AMERICAN
PSYCHOLOGICAL
ASSOCIATION
REPORT OF THE
TASK FORCE ON
Trafficking
of Women
and Girls
TASK FORCE ON TRAFFICKING OF WOMEN AND GIRLS
Nancy M. Sidun, PsyD, ABPP, ATR (Co-Chair)
James O. Finckenauer, PhD
Kaiser Permanente-Hawaii
Rutgers University
Deborah L. Hume, PhD (Co-Chair)
Marsha B. Liss, PhD, JD
University of Missouri
Bethesda, Maryland
AnnJanette Alejano-Steele, PhD
Terri D. Patterson, PhD
Metropolitan State University of Denver
Federal Bureau of Investigation
Laboratory to Combat Human Trafficking
Alexandra (Sandi) Pierce, PhD
Mary C. Burke, PhD
Othayonih Research
Carlow University
Metropolitan State University
Michelle Contreras, PsyD
Massachusetts School of Professional Psychology
Trauma Center at JRI—Project Reach
APA STAFF: WOMEN’S PROGRAMS OFFICE
Shari E. Miles-Cohen, PhD
Senior Director
Tanya L. Burrwell
Assistant Director
Wynter K. Oshiberu
Programs Assistant
REPORT OF THE TASK FORCE ON
TRAFFICKING OF WOMEN AND GIRLS
Available online at http://www.apa.org/pi/women/programs/
trafficking/report.aspx
Grids of the empirical studies used in this report are available as
supplemental material online at http://www.apa.org/pi/women/
programs/trafficking/grids.pdf
Suggested bibliographic reference:
Task Force on Trafficking of Women and Girls. (2014). Report of the Task Force on
Trafficking of Women and Girls. Washington, DC: American Psychological Association.
Retrieved from http://www.apa.org/pi/women/programs/trafficking/report.aspx
Copyright © 2014 by the American Psychological Association. This material may be reproduced in whole or in part without fees or permission provided acknowledgment is given to
the American Psychological Association. This material may not be reprinted, translated,
or distributed electronically without prior permission in writing from the publisher. For
permission, contact APA, Rights and Permissions, 750 First Street, Washington, DC
20002-4242.
APA reports synthesize current psychological knowledge in a given area and may offer
recommendations for future action. They do not constitute APA policy nor commit APA to
the activities described therein. This particular report originated with the Board for the
Advancement of Psychology in the Public Interest.
CONTENTS
Acknowledgmentsv
Physical Health Consequences 44
Additional Consequences 44
Responding to Trafficking of Women and Girls 46
Prevention 46
Protection 50
Prosecution and Partnership 51
Program Evaluation: The Challenge 52
Conclusion 52
The Role of the Psychologist 53
Research 53
Executive Summary 1
Introduction and Overview 13
Purpose 13
Background and Definition 13
Methodology 15
Measuring Human Trafficking 19
Methodological Challenges 19
Prevalence and Incidence 20
Risk Factors for the Trafficking of Women and Girls
22
Education and Training 54
Societal and Public Policy Risk Factors 22
Advocacy and Public Policy 54
Community Risk Factors 27
Public Awareness 55
Institutional Risk Factors 27
Practice 55
Interpersonal and Relationship Risk Factors
28
Self-Care and Safety: Ethical Considerations 59
Individual Risk Factors 30
Conclusion 33
Recommendations 62
General Recommendations 62
Describing Human Trafficking 34
Research Recommendations 63
Traffickers, Facilitators, and Perpetrators 34
Practice Recommendations 65
Means of Trafficking 35
Education and Training Recommendations 66
Public Policy Recommendations 66
Public Awareness Recommendations 67
Consequences and Impact of Trafficking 40
Literature Review 40
Mental Health Consequences 40
Notes69
References 73
ACKNOWLEDGMENTS
We express great appreciation to the Board for the Advancement
Members of the Committee on Women in Psychology (2011–2014)
of Psychology in the Public Interest (BAPPI), the Committee on
Joan C. Chrisler, PhD (2013 Chair); Cynthia de las Fuentes, PhD
Women in Psychology (CWP), and the Women’s Programs Office
(2012 Chair); Ramani S. Durvasula, PhD; Edna M. Esnil, PsyD;
(WPO) for supporting us in the process of examining the traffick-
Kathy A. McCloskey, PhD, PsyD, ABPP; Maureen C. McHugh, PhD
ing of women and girls into and within the United States. Without
(2014 Chair); Sandra L. Shullman, PhD; Nancy M. Sidun, PsyD,
their ongoing support, the task force could not have succeeded in
ABPP, ATR (2011 Chair); Cheryl L.B. Travis, PhD; Earlise C. Ward,
accomplishing its goals.
PhD; Julie L. Williams, PsyD; and Jennifer P. Wisdom, PhD
Specifically, we wish to thank the following individuals:
Women’s Programs Office
Gwendolyn Puryear Keita, PhD
Executive Director, APA Public Interest Directorate
Shari E. Miles-Cohen, PhD
Tanya L. Burrwell
Wynter K. Oshiberu
Members of the Board for the Advancement of Psychology in
Gabriel H. J. Twose, PhD
the Public Interest (2011–2014)
Kari Hill
Toni C. Antonucci, PhD (2014 Chair); Asuncion Miteria Austria,
Sonia Sherry
PhD; Meg Bond, PhD; Y. Barry Chung, PhD; M. Dolores Cimini,
Meghan Albal
PhD; Priscilla Dass-Brailsford, EdD; Linda M. Forrest, PhD; Claire
Heather Durban
Guthrie Gastañaga; Douglas C. Haldeman, PhD (2011 Chair);
Megan Levy
Gary W. Harper, PhD; J. Douglas McDonald, PhD; Jona S. Meier,
Emily Moses
JD; Linda R. Mona, PhD; Gayle L. Skawennio Morse, PhD; Allen
Scott Pine
M. Omoto, PhD (2013 Chair); William D. Parham, PhD; Luis A.
Rebecca Reilly
Vargas, PhD; Elizabeth M. Vera, PhD; Karen F. Wyche, PhD (2012
Marcy Rudins
Chair); and Antonette M. Zeiss, PhD
Paige Tieman
Other Public Interest Staff
For careful reading and copyediting we thank the following:
Leslie Cameron
Gary Hume
Nida Corry, PhD
Gabriele McCormick
Patricia DiSandro
Deborah Farrell
Diane Elmore, PhD
Donella Graham
Susan Houston
Report of the Task
Design Services.
Stephanie Reeves
We would be remiss not to acknowledge Rita Chi-Ying Chung,
Ivana Willis
PhD, an original task force member, and others who contributed
Force on Trafficking
of Women and Girls
The report was designed by David Spears of APA’s Editorial and
We are grateful to the following individuals, APA boards, and
to the conceptualization of this report.
APA committees that provided thoughtful critiques, feedback,
We also gratefully acknowledge those who supported this work
and suggestions. The time and effort they provided significantly
through financial contributions:
strengthened the report:
American Psychological Association Council of Representatives
External Cadre of Experts
Jeanne L. Allert; Claudette Altuna, MSW, LICSW, ACSW, BCD,
MHSA; Noel B. Busch-Armendariz, PhD, LMSW, MPA; Charita L.
Castro, PhD, MSW; Stacey Cecchet, PhD; Megan Cler, PsyD; Angel
Colon-Rivera, PhD; Karen Countryman-Roswurm, LMSW; Katherine
C. Cunningham; Carolina de los Rios, PhD; Smita Ekka Dewan;
Carol A. Dwyer, PhD; Tina Frundt; Bravada M. Garrett-Akinsanya,
PhD; Rivka Greenberg, PhD; Iva GreyWolf, PhD; Helen H. Hsu,
PsyD; Patti Johnson, PhD; Linda Petroff, PhD; Diana L. Prescott,
PhD; Joan A. Reid, PhD, LMHC, CRC; Karen A. Roberto, PhD; Leyla
Strotkamp; Lekeisha A. Sumner, PhD; Linda M. Williams, PhD;
Bincy Wilson; and Jennifer L. Woolard, PhD
APA Boards and Committees
Board of Educational Affairs
Board of Professional Affairs (BPA)
The Board of Scientific Affairs (BSA)
Membership Board (MB)
Policy and Planning Board (P&P)
Committee on Aging (CONA)
Committee on Children, Youth, and Families (CYF)
Committee on Disability Issues in Psychology (CDIP)
Committee on Ethnic Minority Affairs (CEMA)
Committee on International Relations in Psychology (CIRP)
Committee on Legal Issues (COLI)
Committee on Lesbian, Gay, Bisexual, and Transgender Concerns
(CLGBTC)
Committee on Psychology and AIDS (COPA)
Committee of Psychology Teachers at Community Colleges (PT@CC)
Committee on Socioeconomic Status (CSES)
Teachers of Psychology in Secondary Schools (TOPPS)
vi
American Psychological Association Women’s Caucus
Larsson Charitable Foundation
Nimick Forbesway Foundation
Quality Carpentry and Painting, LLC
EXECUTIVE SUMMARY
Human trafficking, a grave contemporary human rights
violation, is characterized by the economic exploitation of an
individual through force, fraud, or coercion (Trafficking Victims
Protection Act [TVPA], 2000; United Nations, 2000). 1 U.S. citizens are involved as both victims and perpetrators of trafficking
within the United States and abroad; the majority of those identified as trafficked in the United States for labor or commercial
sex are women and girls (Kyckelhahn, Beck, & Cohen, 2009; U.S.
Department of State, 2005).
In 2011, the American Psychological Association (APA) established
the Task Force on Trafficking of Women and Girls at the recommendation of APA’s Committee on Women in Psychology (CWP) and
upon approval by the Board for the Advancement of Psychology in the
Public Interest (BAPPI). The purpose of this report is to (a) raise
awareness among psychologists about human trafficking; (b) make
recommendations to enhance research, education and training,
advocacy and public policy, public awareness, and practice as they
pertain to the intersections of psychology and this social problem;
and (c) urge psychologists to bring scientific rigor and research
expertise to bear on policy, service provision, and an understanding
of the dynamics of trafficking.
Methodology
Human trafficking is characterized by exploitation of vulnerable populations and is a violation of the basic human right to
autonomy and freedom affirmed by the Universal Declaration
of Human Rights (United Nations, 1948). In this report, the
task force uses the definition of human trafficking from Article
3, Use of Terms, of the U.N. Protocol to Prevent, Suppress and
Punish Trafficking in Persons, Especially Women and Children
(United Nations, 2000): 2
(a) “Trafficking in persons” shall mean the recruitment, transportation, transfer, harbouring or receipt of persons, by means
of the threat or use of force or other forms of coercion, of
abduction, of fraud, of deception, of the abuse of power or of
a position of vulnerability or of the giving or receiving of payments or benefits to achieve the consent of a person having
control over another person, for the purpose of exploitation.
Exploitation shall include, at a minimum, the exploitation of
the prostitution of others or other forms of sexual exploitation, forced labour or services, slavery or practices similar to
slavery, servitude or the removal of organs;
(b) The consent of a victim of trafficking in persons to the
intended exploitation set forth in subparagraph (a) of this
article shall be irrelevant where any of the means set forth in
subparagraph (a) have been used;
complexity. There is no typical case of human trafficking, which
receipt of a child for the purpose of exploitation shall be
often overlaps with other closely related crimes, such as human
considered “trafficking in persons” even if this does not
smuggling, prostitution, intimate partner violence, and child
involve any of the means set forth in subparagraph (a) of
abuse. Trafficked women and girls are frequently victims of mul-
this article;
tiple crimes. A variety of clinical populations potentially include
Force on Trafficking
of Women and Girls
Research related to human trafficking is challenging due to its
(c) The recruitment, transportation, transfer, harbouring or
(d) “Child” shall mean any person under eighteen years of age.
Report of the Task
Methodological Challenges
A social ecological model (McLeroy, Bibeau, Steckler, & Glanz,
1988), used as the framework for this report, highlights the contributions of individual, interpersonal, institutional, community, and
societal factors as they pertain to human trafficking. Successful
prevention approaches need to take into account more than the
vulnerabilities of individual women and girls. Prevention efforts
must consider the institutional structures, social norms, and policy
factors that can empower those individuals or constrain individ-
trafficking victims.
Human trafficking is also extremely difficult to measure. The clandestine nature of the crime, the lack of a comprehensive centralized
database of human trafficking cases, the sheer diversity of trafficking situations and experiences, and the difficulty in accessing
persons with knowledge of the phenomenon, including trafficked
women and girls themselves, contribute to the gaps and weaknesses in the empirical research (Farrell et al., 2010, 2012; Hopper,
2004; Weiner & Hala, 2008).
ual agency and options. In addition, a focus on reducing demand
There is currently no reliable estimate of the prevalence or
for commercial sex and for goods produced by exploitive labor is
incidence of trafficking of women and girls in the United States
integral to preventing human trafficking.
(Farrell et al., 2010; Hopper, 2004). Shifts in estimates published
The task force identified literature published since 1980 pertaining
to the trafficking of women and girls into and within the United
States. Because this is a relatively new research area, there are
a limited number of empirical studies published. We cast a wide
in the U.S. Department of State’s annual Trafficking in Persons
Report are indicative of the difficulty in determining prevalence
and incidence (Miko & Park, 2002; U.S. Department of State,
2003, 2005, 2006).
net to capture all relevant research, capitalize on the unique con-
There is no typical case of human
Characteristics of Trafficking
trafficking, which often overlaps
RISK FACTORS
with other … crimes, such as human
individual’s characteristics and personal history within a complex
smuggling, prostitution, intimate partner
condone labor and sexual exploitation, tolerate or fail to regulate
violence, and child abuse.
and marginalization all contribute to trafficking (Brennan, 2008;
tributions of multiple methodological approaches, and determine
which findings are supported by converging evidence from multiple
approaches. Thus, the review includes studies that used qualitative, quantitative, or mixed methodologies; large or small sample
sizes; and case studies, ethnography, and community-based participatory research, among other approaches. Each methodological
approach offers a unique lens and contributes to a more complete
picture of human trafficking.
2
Vulnerability to human trafficking results from a nesting of an
and dynamic system of external factors. Conditions that permit or
unscrupulous business practices, or maintain status inequalities
Chacon, 2006; Heyzer, 2002; Van Liemt, 2004). Globalization, poverty, social and political instability, and war and military presence
magnify the risk of trafficking (APA Presidential Task Force on
Immigration, 2012; Aronowitz, 2009; Danailova-Trainor & Belser,
2006; Farr, 2005; Nikoli -Ristanovi , 2002a; O’Neill Richard, 2000;
Trujillo, 2004; Watts & Zimmerman, 2002). Factors that undermine
the ability to protect oneself or disrupt the connections to social
and familial support also increase susceptibility to psychological
coercion (Albanese, 2007; Lloyd, 2011; Norton-Hawk, 2002; Pierce,
2009; Raphael & Ashley, 2008; Reid, 2010). In addition to gender,
PTSD (Jung, Song, Chong, Seo, & Chae, 2008; McClanahan,
variables contributing to a person’s vulnerability include individ-
McClelland, Abram, & Teplin, 1999; Sallman, 2010). 3
ual attributes such as age; membership in a marginalized group;
prior victimization and trauma; developmental, emotional, and
cognitive factors; disabilities; immigrant or refugee status; and
family disruption (Pierce, 2009; Ugarte, Zarate, & Farley, 2003;
Van Dorn et al., 2005).
Executive Summary
TRAFFICKERS
Those who recruit, transport, and exploit women and girls span the
continuum from a single individual to organized networks (Bruckert
& Parent, 2002; UN Office on Drugs and Crime [UNODC], 2010).
The most effective recruiters are those who already have, or who
can establish, a trusting relationship with the potential victim or
Physical consequences can include neurological issues, gastrointestinal disturbances, respiratory distress, chronic pain, sexually
transmitted diseases (including HIV), urogenital problems, dental
problems, fractures, and traumatic brain injuries (Burnette et
al., 2008; Farley et al., 2003; Farley, MacLeod, et al., 2011).
The extremely limited research addressing the consequences
of labor trafficking reveals that trafficked women and girls in
forced labor are at high risk for physical injury, exposure to work
hazards, and generally deplorable working conditions (Free the
Slaves & the Human Rights Center, 2004; Human Rights Center,
2005; Human Rights Watch, 2001, 2012).
with victims’ families (Human Rights Center, 2005). No consistent
profile of a trafficker exists: He or she may be a family member, an
acquaintance, an intimate partner, a known and trusted member
of the victim’s community, or a stranger (Kingsley & Mark, 2000;
Pierce, 2009; Sidun & Rubin, 2013; UNODC, 2009).
Responding to Trafficked
Women and Girls
Effective anti-trafficking programming in the United States is in
MEANS OF TRAFFICKING
its infancy. As a result of professional training and community
Traffickers use coercion and psychological abuse, deception and
awareness programs, early identification of human trafficking
fraud, threats, physical and sexual violence, abusive work and liv-
should increase the chances that women will receive services and
ing conditions, and coerced substance use to lure, manipulate, and
be able to escape or exit the trafficking situation. Prevention,
control their victims (Bauer, 2007; Hynes, 2002; Kennedy, Klein,
protection, prosecution, and partnership (the “4 Ps”) currently
Bristowe, Cooper, & Yuille, 2007; O’Neill Richard, 2000; Pierce &
serve as the “fundamental international framework used by the
Koepplinger, 2011). Use of the Internet and communications tech-
United States and internationally to combat contemporary forms
nology has become an important tool in trafficking as well (Arizona
of slavery” (U.S. Department of State, 2011a).
State University, 2012; Blevins & Holt, 2009; Reid, 2010).
PREVENTION
CONSEQUENCES
and educational campaigns are intended for both
• Awareness
Trafficked women and girls experience severe and potentially
primary prevention (reducing vulnerability to trafficking) and sec-
life-threatening physical and mental health consequences,
ondary prevention (early victim identification and intervention).
which can be lifelong. They encounter high rates of physical and
sexual violence, including homicide and torture, psychological
abuse, horrific work and living conditions, and substance abuse
(Aronowitz, 2009; Hynes, 2002; Oram, Stöckl, Busza, Howard, &
Zimmerman, 2012; Pierce, 2009; Potterat et al., 2004; Raymond
et al., 2002; Sarkar et al., 2008). Women trafficked into the
United States may also encounter extreme deprivation while in
transit (Raymond et al., 2002). Serious mental health problems
result, including anxiety, depression, self-injurious behavior, suicidal ideation and suicide, drug and alcohol addiction, posttraumatic stress disorder (PTSD), dissociative disorders, and complex
3
• Empowerment
programs build protective factors, such as
education and career counseling, and address risk factors and
barriers to exiting, such as homelessness, substance use, history
of violent victimization, and unavailability of support.
• Demand
reduction programs target sex buyers and attempt to
change social norms about commercial sex.
• Policy efforts at the local, state, national, and international
level also address prevention, although most U.S. policy
focuses on prosecution of traffickers and services for victims,
which may reduce revictimization but do not address primary
prevention needs.
Report of the Task
Force on Trafficking
of Women and Girls
The Role of the Psychologist
Psychology can and must address human trafficking in all pro-
Although many prevention approaches seem promising, their
fessional capacities: research, education and training, advocacy
impact in terms of reducing victimization is largely unknown, and
and public policy, public awareness, and practice. The issue
there is limited reporting on these programs in the peer-reviewed
must be addressed at multiple levels of the social ecological
literature. Prevention initiatives may need to be strategically
model, from individual protective and risk factors to societal and
distinct for domestically and internationally trafficked persons.
policy factors.
PROTECTION
Protection measures “ensure that human trafficking victims
are provided access to health care, counseling, legal, and
shelter services in ways that are not prejudicial against vic-
• Psychologists who conduct research have a critical role to play
in conceptualizing, designing, conducting, analyzing, and publishing investigations related to human trafficking.
• Psychologists involved in education and training at the under-
tims’ rights, dignity, or psychological well-being” (Laboratory
graduate, graduate, and postdoctoral levels can incorporate the
to Combat Human Trafficking, n.d.). Much of the responsibility
topic of human trafficking into their courses, seminars, and case
for protecting and meeting the needs of survivors of traffick-
conferences.
ing is assumed by a host of nongovernmental organizations
(NGOs). The primary challenges to meeting survivors’ needs
are (a) lack of sufficient training to identify human trafficking
when encountered, (b) inadequate resources (trained staff,
funding, etc.) to meet client needs, (c) limited communication
and planning between agencies, (d) a shortage of resources
to evaluate the effectiveness of service provision, and (e)
challenges in working with law enforcement agencies (Caliber,
2007; Jones & Yousefzadeh, 2006).
PROSECUTION AND PARTNERSHIP
• By engaging in education and advocacy, psychologists can
share their knowledge of psychological science with policymakers to “contribute to the formulation of sound public policy to
address health and social issues and improve human welfare”
(APA, 2010b, p. 7). Policymakers at all levels—federal, state,
and local—would benefit from information about populations at
risk for trafficking, contributing factors, means of trafficking,
identification of trafficked persons, and the consequences of
exploitation for individuals and communities.
• Psychologists can contribute to public awareness of human traf The complexity of human trafficking investigations makes collabo-
ficking by translating complex research findings into information
ration and coordination among a variety of entities and juris-
accessible to the general public. Community and social psy-
dictions necessary (Farrell, McDevitt, & Fahy, 2008; Venkatraman,
chologists’ expertise can also contribute to developing effective
2003). The most common law enforcement strategy in response to
ways to educate specific audiences.
trafficking has been to form and rely on joint task forces made up
of state, local, and federal agencies, including law enforcement,
social service providers, and mental health providers, among others
(Clawson, Dutch, & Cummings, 2006).
PROGRAM EVALUATIONS
Responses to human trafficking in the United States are not always
guided by a comprehensive understanding of the problem. To date,
there is a notable lack of outcome evaluation (Clawson, Dutch,
Salomon, & Goldblatt Grace, 2009; Laczko & Danailova-Trainor,
2009; van der Laan, Smit, Busschers, & Aarten, 2011). The field is
Psychologists practice in many arenas and with thorough training can contribute to human trafficking prevention, protection
of trafficked persons and potential victims, and prosecution of
traffickers. Clinical and counseling psychologists can provide
psychotherapy, forensic evaluation, career counseling, and other
services. School psychologists can train other school personnel
on trafficking issues, develop prevention programming for youth,
or identify at-risk students. Forensic psychologists can work
within law enforcement agencies on investigative and prosecutorial responses to trafficking.
in need of systematic, high-quality research to determine program
The central challenge of providing psychotherapy services to
efficacy in preventing trafficking, protecting victims, and prosecut-
survivors of human trafficking is the dearth of clinical research
ing those engaged in the crime of human trafficking.
identifying best practices for this population. The needs of
4
trafficking survivors are extensive and complex (Shigekane,
have left” because they may not have been physically confined
2007), and psychologists have an obligation to gain competency
and that the victim is a “bad witness” because of her behavior
regarding this population’s unique constellation of mental health
and demeanor.
problems before providing treatment to trafficked women and
girls. Competency in multiculturalism and diversity is essential to
effective practice; psychologists need to attend to the intersections of race, ethnicity, language, sexual orientation, gender, age,
ability, class status, education, religion/spirituality, developmenExecutive Summary
tal stage, and culture (APA, 2008).
Self-Care and Safety:
Ethical Considerations
Psychologists and organizations that provide services to trafficked
In many parts of the United States, survivors have limited access
individuals must proactively prepare for the potential effects of
to service providers with specialized training in the unique
working with traumatized clients. Awareness, education, ongoing
psychological needs of trafficking victims (Adams, 2010; Chung,
self-care, and a supportive work culture are essential to the
Bemak, Ortiz, & Sandoval-Perez, 2008; Yakushko, 2009). Because
well-being of psychologists and to the responsible and effective
victims of trafficking are likely to have experienced multiple and
treatment of trafficked persons.
persistent traumas, a trauma-informed approach to treatment is
essential. A wealth of literature describes effective and empiri-
SELF-CARE
cally based interventions with survivors of trauma (Cook et al.,
Psychologists working with trafficked individuals need to pay spe-
2005), and until interventions specific to the needs of trafficked
cial attention to their own well-being (International Organization
women and girls are developed, it is reasonable to recommend
for Migration [IOM], 2009; Kliner & Stroud, 2012). Providing
the current guidelines applied to the treatment of survivors of
trauma-focused treatment is emotionally complex and demanding
other abuses. Psychologists should remain aware that trafficking
(Figley, 2002; Meichenbaum, 2007). Distress can fuel burnout,
survivors may present with many issues, requiring a holistic
secondary traumatic stress (STS), vicarious traumatization (VT),
approach to services.
and compassion fatigue (CF), which can include exhaustion,
Psychologists working on complex trauma and complex PTSD
issues can continue to inform and enhance an understanding of
best practices and effective interventions (Cloitre et al., 2011;
Courtois, 2008). Working in conjunction with women and girls
who have been trafficked to develop appropriate and effective
emotional numbing, a sense of reduced personal effectiveness,
PTSD-like symptoms, and a variety of somatic disturbances (IOM,
2009; Jenaro, Flores, & Arias, 2007; Kliner & Stroud, 2012; McCann
& Pearlman, 1990; Meichenbaum, 2007; Perron & Hiltz, 2006; P. L.
Smith & Moss, 2009; Yassen, 1995).
therapeutic techniques is essential. Practitioners working to
Psychologists have an ethical responsibility to (a) be cognizant
establish therapeutic techniques for trafficked women and girls
of the possibility of burnout, STS, VT, and CF; (b) understand the
can develop diagnostic, evaluation, and treatment guidelines
impact these conditions have on the therapeutic relationship;
that describe professional competencies and prescribe ethical
and (c) engage in self-care measures to prevent and mitigate
and responsible care of the individuals they serve.
impairment in their work (APA, 2010a; E. K. Baker, 2003; Barnett
Finally, psychologists can play key roles within criminal justice
systems by assisting in interviews and evaluations of victims.
Trafficking survivors who are well advanced in their recovery
& Cooper, 2009; Carroll, Gilroy, & Murra, 1999; Good, Khairallah,
& Mintz, 2009; Meichenbaum, 2007; Norcross & Barnett, 2008;
P. L. Smith & Moss, 2009).
process can provide invaluable assistance to psychologists and
Supervisors, managers, and organizations that educate or employ
forensic interviewers regarding trafficking dynamics and ways to
psychologists also have an ethical responsibility to promote “a
avoid retraumatizing the client (Pierce, personal communication,
culture of self-care” (Barnett & Cooper, 2009, p. 16). First and
April 29, 2013). Social psychologists can help jurors and judges
foremost, this includes honest acceptance that STS, VT, and CF can
understand the psychological mechanisms by which people can
occur and that measures should be taken to reduce their likelihood
be coerced and manipulated and their freedom constrained; they
and to address them when they arise.
can address the misperception that trafficking victims “could
5
SAFETY CONSIDERATIONS
that transcend the topic areas and are essential to all aspects
Psychologists who work with trafficked women and girls need
of work in psychology.
to be mindful of safety for their clients, for themselves, and
for their places of work, especially if the trafficker is under
GENERAL RECOMMENDATIONS
criminal investigation or prosecution (IOM, 2009). Maintaining
It is recommended that psychologists:
absolute confidentiality about clients who have been trafficked
is essential for safety (IOM, 2009). For the safety of providers,
agency staff, and clients, clear guidelines should be developed
Report of the Task
for confidentiality protocols, employee responsibilities, building
Force on Trafficking
security, emergency communication and planning, and staff
of Women and Girls
education and training.
Zimmerman and Watts (2003, p. 4) provided excellent guidelines
for interviewing trafficked women and girls that capture the
essential need for ethical, respectful, and safe interactions. The
guidelines are intended for service providers and researchers
working with this population as well as media professionals. A
• Examine
their assumptions and biases toward at-risk groups as
they consider engaging in work on human trafficking issues.
Stereotypes related to immigrants and undocumented migrants,
runaway or homeless youths, persons with addictions, or
individuals in prostitution can impede identification of human
trafficking survivors and their unique needs.
• Be
culturally sensitive in all endeavors related to human
trafficking (research, education and training, advocacy and
public policy, public awareness, and practice).
cognizant that internationally and domestically traf• Remain
full explication of their recommendations is beyond the scope of
ficked persons are a diverse and multicultural group.
this report, but the 10 guiding principles are:
Psychologists must be able to adapt their professional work
1. Do no harm.
2. Know your subject and assess the risks.
3. Prepare referral information—Do not make promises
you cannot fulfill.
4. Adequately select and prepare interpreters and coworkers.
5. Ensure anonymity and confidentiality.
6. Get informed consent.
7. Listen to and respect each woman’s assessment of her
situation and risks to her safety.
8. Do not retraumatize a woman.
9. Be prepared for emergency intervention.
10. Put information collected to good use.
accordingly.
that no “one-size-fits-all” approach exists to
• Recognize
comprehensively address the victim/survivor experience.
No single law enforcement or victim services protocol will suffice
in every case. Remaining flexible with regard to conceptualization is a critical skill given the many possible intersections
of victim characteristics (minor or adult, domestic or foreign
national, among others), as well as the multiple labor and commercial sex settings in which trafficking occurs.
that their work occurs within a social eco• Acknowledge
logical system that includes larger community and cultural
influences and that changes in one level of the system may
have wider implications.
Psychologists should remain aware that psychological
approaches do not exist in a vacuum. For example, policy change
in the name of anti-trafficking efforts may create unintended
consequences for other vulnerable communities (such as clients
of child welfare systems or immigrants).
Recommendations
The Task Force on Trafficking of Women and Girls offers specific
recommendations in the following topic areas: research, practice, education and training, public policy, and public awareness. In addition, the task force offers general recommendations
• Support
the creation of cultural shifts among law enforcement and service providers in anti-trafficking efforts
to create a greater understanding of and respect for all
trafficked populations.
For example, community and social psychologists can address
law enforcement and service provider attitudes toward marginalized populations as groups “worthy” of support and access to
6
services by providing specialized training regarding the nature of
Trafficked persons who have experienced powerlessness may
trafficking and its victims.
perceive research settings that are inherently hierarchical to
the impact of paternalistic attitudes and the “rescue”
• Examine
approach on survivors’ outcomes and well-being.
This approach must be guarded against in U.S. policy, NGO programs, and individual treatment. Paternalistic attitudes toward
survivor inclusion in policymaking, program planning, and proExecutive Summary
gram evaluation sideline expertise and silence essential voices.
for survivor-centered, survivor-informed, and survi• Advocate
be overpowering. Therefore, mixed methodologies (e.g., qualitative and quantitative, with an overarching participatory action
research lens) may be better suited to concurrently obtain
empirically supported results while paying attention to important
ethical concerns.
• Community-based
participatory research be considered as
one promising approach to addressing this topic.
vor-led efforts guiding policymaking, protocol development,
It is recommended that research be conducted in the
research design, methodology, and clinical approaches.
following areas:
For example, community-based research should be conducted
with the input of affected individuals, taking time to build and
maintain trusting collaborative relationships.
• Increase
focus on prevention of human trafficking at all
levels of the social ecological system.
• Support
recommendations of the APA Task Force on the
Sexualization of Girls (2010) regarding social norms, attitudes,
and culture of tolerance for sexual exploitation.
Prevention/Demand
• Prevention
of human trafficking at all levels of the social
ecological model.
This includes examining risk factors such as child sexual abuse,
child neglect, parental abandonment, racial and ethnic discrimination, homelessness, and marginalization due to sexual identity,
sexual orientation, disability, or immigrant status.
• Role
that objectification of women and girls plays in the
proliferation of human trafficking and in fueling the demand
RESEARCH RECOMMENDATIONS
To address the limitations of the current research base as
discussed at length in this report, particularly the absence of
research on trafficking of women and girls for forced labor, of
women and girls into and within the United States, and on the
efficacy of programs and treatment modalities for survivors, it is
recommended that:
• The
complexity of human trafficking issues be addressed with
an interdisciplinary and multisector response.
Transnational and domestic trafficking of women and girls
occurs within systems of global and domestic trade, voluntary
and forced migration, economic disparities, and structural
inequalities. In addition, legal and governmental factors such
as the existence or lack of labor laws, criminal justice procedures, and child welfare systems impact trafficking situations.
The complexity of the issue requires a multisector response, and
interdisciplinary research is necessary for that response to be
optimally effective.
methodologies be developed and conducted in collab• Research
oration and consultation with survivors and clinicians who have
substantial experience providing services to this population.
for commercial sexual exploitation.
• Role
of women’s empowerment, equity, and rights in the
prevention of trafficking.
• Potential
role of religion and religious practices in relation
to trafficking recruitment and recovery.
cross-disciplinary collaboration and partnerships
• Effective
for prevention.
• Consumer
and business models for reducing demand for
products made with forced labor and factors impacting consumer attitudes and behavior.
• Effectiveness
of primary prevention efforts targeting girls
and women.
• Link
between pornography and sex trafficking, including trafficking for the purpose of producing pornography, the use of
pornography by traffickers, and the potential for pornography
to fuel trafficking via increased demand.
Anecdotal evidence suggests traffickers may use pornography to
“train”
women and girls for commercial sex work and also as a
coercion method (e.g., threatening to show family the pornographic
material involving the victim if she does not comply).
7
• Demographics,
characteristics, and motivations of consumers of goods and services that involve trafficking, especially
commercial sex.
and trafficking.
• Demand
Force on Trafficking
of Women and Girls
trafficking of others and the determinants of this behavior.
Trafficked Persons
• Interactions
of situational and individual characteristics (e.g.,
Psychologists can collaborate with groups that work on rehabili-
developmental, cultural, demographic) as they apply to human
tating consumers of commercial sex to build methodologies that
trafficking vulnerability, resistance, resiliency, and recovery.
contribute to an understanding of demand in the United States.
Report of the Task
• Degree
to which formerly trafficked persons engage in the
Identification
• How
information processing, social perception, schemas,
and labeling impact the ability of professionals to identify
perpetrators and victims of human trafficking in the field and
to respond appropriately.
• Better
understanding of common contributing factors regard-
• Post-trafficking
social support and relationships.
Because traffickers commonly prey on women and girls by establishing a trusting, albeit false, relationship with them, studies on
the impact of trafficking on relationships will be especially helpful.
• Long-term
impact of the trafficking experience throughout
the life course of survivors.
For example, the impact of prolonged exposure to violent pornog-
ing areas that may involve trafficking but have not been
raphy or of forced abortions on survivors’ sexual and reproductive
examined as such (e.g., survival sex, stripping, pornography).
health warrants investigation.
Biases
• How
depictions of human trafficking impact justice for and
empowerment of survivors.
Depictions may impact how victims perceive themselves (including whether they identify as victims of a crime) and how the
justice system responds (e.g., jury perceptions and decisions,
prosecutors’ willingness to take cases, assumptions about “good
witnesses” and “good victims,” and judges’ rulings). Failure to
represent the diversity of trafficking situations or to recognize
the resiliency and agency of trafficking survivors may impact how
services are provided. This could include examination of depictions of trafficking in the media, government-produced public
• Overlap
of intimate partner violence and sex trafficking.
• Impact
of gender nonconformity and gender fluidity on vulnerability to trafficking.
• Trafficking
of men and boys for labor and for commercial sex.
• Religious
and spiritual factors pertinent to trafficking (e.g.,
risk and recruitment), survivor resilience and recovery, and
service delivery (e.g., how the faith orientation of groups
providing services impacts the well-being of survivors).
Trauma
• Types
of trauma exposure during and after trafficking, with
service announcements, outreach materials, and NGO logos and
specific focus on exposure to psychological and physical
websites. It could also be fruitful to examine the language of
coercion, resulting sequelae, and areas of functioning that
policy and rhetoric in the anti-trafficking movement.
are impacted.
Traffickers
• Trafficker
coercion tactics, especially psychological tactics.
• Typology
of traffickers, including characteristics and con-
• Trauma’s
impact on decision making, willingness to cooperate with law enforcement, willingness to receive services,
and vulnerability to revictimization.
bonding, or Stockholm syndrome, in cases of
tributing factors (e.g., factors that determine whether people • Traumatic
become traffickers).
• Comparison
of sex traffickers to other types of sex offenders
(e.g., rapists, child molesters) to determine whether current
criminal justice responses, mental health treatment, and
rehabilitation and reentry protocols applied to sex offenders
are appropriate for sex traffickers.
8
human trafficking.
• Factors
that reduce the risk of trauma-related sequalae in
affected populations (e.g., resilience of trafficked persons).
Labor
• Risk
factors for trafficking into domestic service, agricultural production and meat processing, service industries
(e.g., salons, restaurants, hotels), and other locations of
women and girls. The task force recommends that to address the
labor trafficking.
unique needs of trafficked persons competently, psychologists:
• Biopsychosocial
effects of slavelike and exploitative
service providers, law enforcement personnel, health care
A thorough examination of the experiences of persons trafficked
providers, and other professionals who may encounter victims.
for labor, including psychological impact and health consequences, is lacking in the current literature.
Executive Summary
• Develop
more effective screening tools for therapists, social
work environments.
• Public
attitudes about and media depictions of labor trafficking.
• Consider
comprehensive and coordinated community-level
responses in supporting victims and survivors.
Psychologists are encouraged to develop and maintain partner-
It would be informative to examine factors contributing to the
ship protocols with law enforcement personnel, social workers,
relatively low profile of labor trafficking in research, academic
and victim service networks (depending on the needs and
writing, and public discourse.
request of survivors) to help streamline and support efficient
Program and Treatment Evaluation
• Program/practice
evaluation using randomized control
community response.
• Strive
for partnership with and coordination of efforts
designs and quasi-experimental designs when appropriate
between protection, prosecution, and prevention sectors. and ethical.
For example, service providers and law enforcement personnel
• Strengths,
limitations, and successes of organizations with
survivor leadership and survivors on staff or as peer mentors.
can coordinate their efforts to support survivors more efficiently.
• Apply
psychological theories of healthy personality and iden-
It is essential to determine factors contributing to successful
tity development, thriving, and psychological growth during
models and to identify best practices, as the number of service
the recovery process for survivors of trafficking.
agencies is growing rapidly.
• Development
and evaluation of successful exit programs and
support programs.
• Educate
themselves about developmental factors that impact
trafficking risk, response to the trauma of trafficking, and
efficacy of treatment with different age groups.
the companies with which organizational psychologists
• Development
and evaluation of appropriate individual and group • Assist
treatments to address the psychological impacts of trafficking.
consult through technical assistance and training, implemen-
Group therapy has been used effectively in some programs (Ward
tation of prevention strategies, and development of business
& Roe-Sepowitz, 2009), but anecdotal evidence suggests support
models for monitoring subcontractors, recruiters, supply
groups may be less effective with some populations because of
chains, and other practices that may conceal trafficking.
the circumstances of their trafficking (Shigekane, 2007). Further
Of special interest are companies that outsource services where
exploration is needed.
trafficking is more prevalent (e.g., hired cleaning crews, subcon-
• Protocols
for meeting needs of trafficking victims (i.e., shelter, health care, trauma-focused counseling, substance use
counseling, education, job training, etc.), including guidance
on how to prioritize and provide treatment needs in the most
efficient and cost-effective way.
• Impact
of developmental variables on treatment choice
and success.
PRACTICE RECOMMENDATIONS
tracted construction labor, suppliers of manufacturing components). In addition, in settings where traffickers or trafficked
persons might be encountered (e.g., airports, hotels, border customs checks, emergency rooms), psychologists are encouraged to
consult with personnel to increase identification and awareness
of trafficked persons.
avenues for practitioner self-care and support self-care
• Identify
for other professionals involved in anti-trafficking work (law
enforcement, service providers, health care, educators, etc.).
As practitioners, psychologists perform critical services by provid-
In addition, it is recommended that APA make the Report of
ing direct treatment, developing treatment protocols, and
the Task Force on Trafficking of Women and Girls available
consulting with organizations/businesses regarding trafficked
to all practitioners to familiarize them with consequences of
9
being trafficked and treatment recommendations relevant to
trafficked persons.
EDUCATION AND TRAINING RECOMMENDATIONS
To increase knowledge and awareness of trafficking, specifically its prevalence and devastating consequences, within the
discipline of psychology and among psychologists, the task force
recommends that:
Report of the Task
Force on Trafficking
of Women and Girls
• Psychological
theory and research be used to develop
effective communication materials and training curricula to
• The
importance of and ethical imperative for self-care be
emphasized in course work and training.
• Psychologists
who supervise practicum students, interns, or
postdoctoral residents be well versed in and have extensive
knowledge of human trafficking.
• A continuing education and online program be developed
using information from the Report of the Task Force on
Trafficking of Women and Girls, in collaboration with APA’s
Office of Continuing Education in Psychology.
curricula and communication materials be developed by
maximize learning among multiple sectors that interface with • All
trafficked persons or are involved in prevention efforts.
professionals with appropriate background in and knowledge
This would include service providers, policymakers, law enforce-
of trafficking and be evaluated for effectiveness.
ment personnel, health care professionals, businesses, educators,
and others.
• Research
on information processing, social perception,
schemas, and labeling be used to address misperceptions and
failures of identification of trafficked persons.
This research should also be incorporated into training curricula.
disseminate the Report of the Task Force on Trafficking
• APA
PUBLIC POLICY RECOMMENDATIONS
To promote deeper understanding of all aspects of trafficking of
women and girls, the task force recommends that psychologists:
funding of research related to human trafficking.
• Support
for the development and implementation of
• Advocate
evidence-based, developmentally appropriate, culturally
of Women and Girls to school psychologists, educators,
appropriate, and trauma-informed services for survivors of
and faculty at the elementary, middle-school, high-school,
human trafficking.
and undergraduate levels and to chairs of graduate depart-
Promote the integration of behavioral health services in settings
ments of psychology. where trafficking survivors reside and receive services, including
School psychologists and educators need to be informed about
schools, victim services, communities, foster and residential
(a) identification of students at risk for trafficking; (b) fortify-
care, juvenile justice, criminal justice, and health care.
ing those at-risk youths with skills to withstand manipulation
and advances; (c) empowering youths to recognize and value
healthy, noncoercive relationships; (d) helping youths distinguish
between legitimate job opportunities and fraudulent “too-goodto-be-true” offers; and (e) encouraging critical discussion of the
glorification of pimp culture, sexualization of girls and women,
and demand for commercial sex.
• Chairs
of graduate departments of psychology, chairs of
departments in related disciplines (e.g., law, social work,
public health, public policy, human development and family
studies, criminal justice), as well as other relevant professionals or community partners, be encouraged to use
information from the Report of the Task Force on Trafficking
of Women and Girls in curriculum development and to aid in
the dissemination of the report.
• Promote
and inform the education and training of health,
educational, law enforcement, legal, child welfare, and social
service professionals on the causes, signs, and consequences
of human trafficking, including mental health aspects, to
ensure that individuals are appropriately identified as at risk
for or as survivors of trafficking.
Identified individuals should be offered appropriate resources,
services, and support to ensure safety and optimal medical and
mental health outcomes.
• Support
evidence-based policies and programs to meet the
needs of girls as the fastest growing segment of the juvenile
justice system.
Address the substantial overlap between involvement in the
justice system and in human trafficking. For example, support
investments in competitive grant programs to help states and
localities better address the needs of girls in the juvenile and
10
criminal justice systems and to provide specific, targeted sup-
appropriate and in the best interest of the trafficking survivor,
port for state efforts to implement best practices for at-risk and
as consistent with the APA Resolution on Immigrant Children,
system-involved girls.
Youth, and Families (1998) (adapted from the recommenda-
addressing human trafficking in legislation and fed• Advocate
Executive Summary
tions of the APA Presidential Task Force on Immigration, 2012).
eral and state initiatives relating to runaway and homeless
• Advocate
review of immigration policy, including examination
youth, child welfare services, and foster care and adoption
of the temporary work visas and guest-worker programs, to
assistance programs.
eliminate abusive labor conditions.
• Advocate
inclusion of information about sex-trafficking prac-
• Promote
protection of human rights for all workers in the
tices and prevention, intimate partner violence prevention,
United States through support for humane and just labor
sexualization, objectification, and healthy relationships in
standards, enforcement of labor laws, and protection of
school health and related programs, including comprehensive
workers’ interests.
sex education and other sexuality education programs.
• Support
policy that recognizes trafficked persons coerced
into illegal activities (e.g., prostitution) as victims rather
than criminals.
• Promote
the development and utilization of empirically
supported curriculum models and media literacy programs,
including interactive media to prevent trafficking and
potentially counteract the effect of sexualization and objectification of girls.
Interventions should be evaluated for effectiveness and potential
wide-scale adoption and should assess the impact of sexualization on girls and boys and consider important factors such as
race or ethnicity, sexual orientation, religious affiliation, disability
status, and socioeconomic status, consistent with the recommendations of the Report of the APA Task Force on the Sexualization
of Girls (APA, Task Force on the Sexualization of Girls, 2010).
• Advocate
for effective behavioral health and educational
• Examine
the impact of the current economic climate and
policy on the well-being of the workforce.
careful examination of the connection between
• Advocate
free-trade policies and trafficking of persons into the United
States and to produce goods for U.S. consumption.
• Promote
policies that will provide access to lifelong health
and mental health care to address the long-term and chronic
health issues faced by survivors of trafficking.
PUBLIC AWARENESS RECOMMENDATIONS
To raise awareness of trafficking, the task force recommends that
public awareness campaigns be used to:
• Address
common misperceptions and myths about trafficking victims.
• Increase
awareness that human trafficking occurs within the
United States in all types of communities.
supports for immigrant-origin children, adolescents, and
As such, awareness campaigns must be adapted for use in
adults who have suffered from or are vulnerable to human
diverse and multicultural communities.
trafficking, as consistent with the recommendations of the
APA Presidential Task Force on Immigration (2012).
• Continue
to raise awareness of the behavioral health effects
of detention and deportation processes on immigrant
trafficking survivors and their families (adapted from the
recommendations of the APA Presidential Task Force on
Immigration, 2012).
• Promote
immigration policies that support trauma-informed,
developmentally appropriate, and culturally responsive
behavioral health services and that recognize the importance
of family reunification in immigration proceedings when
11
• Increase
awareness of both labor and sex trafficking.
• Educate
the public about common signs of human trafficking
to help identify potential victims in their communities.
Psychologists can be especially helpful in educating about signs
of psychological coercion––often subtle and difficult to identify––in trafficking (e.g., grooming, traumatic bonding).
• Emphasize
prevention for parents and youth.
• Include
multilevel training created by long-term survivors who are advanced in their own healing and have the
necessary experience, professional skills, and training to
work with economically and culturally diverse stakeholders.
• Respect
the varied lived experiences of human
trafficking survivors.
Ensure that images are neither exploitive nor sensationalist in
nature to prevent stereotypical images of human trafficking
survivors. When public awareness programs include survivors as
Report of the Task
Force on Trafficking
of Women and Girls
speakers, the organizers and other speakers should be mindful of
avoiding unintentionally presenting survivors as “token” examples, or worse, “specimens” to be examined.
It is also recommended that:
• Public
service announcements provide survivor hotline numbers in addition to the Human Trafficking Resource Center
hotline number.
Institutions that may serve trafficked persons or may be locations of trafficking should post public service announcements
with hotline numbers.
• Public
awareness curricula address intersections and overlaps with other forms of violence (e.g., child abuse, intimate
partner violence), exploitation (e.g., labor exploitation and
violations), and vulnerable communities (e.g., immigrants,
refugee/asylees, homeless youth).
12
INTRODUCTION
AND OVERVIEW
Purpose
acknowledge that many forms of human trafficking are equally
The existence of human trafficking underscores society’s ongoing
struggle to secure equality and human rights for all its members.
Human trafficking is defined as the economic exploitation of an
devastating,the focus of this report is in accordance with the
mandate from CWP: women and girls trafficked into or within the
United States for purposes of labor or commercial sex. 3
individual at the hands of another through force, fraud, or coer-
Psychologists in all areas of the discipline can play a meaningful
cion (Trafficking Victims Protection Act of 2000 [TVPA]; United
role in addressing human trafficking through research, educa-
Nations, 2000). 1 U.S. citizens are both victims and perpetrators
tion, advocacy, and provision of clinical services. Attention by
of this crime in the United States and abroad.
APA and its members to human trafficking is in clear alignment
In 2011, the American Psychological Association (APA) established
the Task Force on Trafficking of Women and Girls at the recommendation of APA’s Committee on Women in Psychology (CWP) and
upon approval by the Board for the Advancement of Psychology in
the Public Interest (BAPPI). The purpose of this report is to
with its mission “to advance the creation, communication, and
application of psychological knowledge to benefit society and
improve people’s lives.” It is hoped the content of this report will
move readers to action through advocacy and by addressing task
force recommendations in their professional activities.
(a) raise awareness among psychologists about human trafficking; (b) make recommendations to enhance research, education
and training, advocacy and public policy, public awareness, and
practice as they pertain to the intersections of psychology and
this social problem; and (c) urge psychologists to bring scientific
rigor and research expertise to bear on informing policy, service
provision, and an understanding of the dynamics of trafficking.
Background and Definition
Human trafficking is characterized by exploitation of vulnerable populations and is a violation of the basic human right to
autonomy and freedom (Universal Declaration of Human Rights;
United Nations, 1948). This report uses the definition of human
In this report, the task force examines and summarizes the
trafficking from Article 3, Use of Terms, of the U.N. Protocol to
literature on human trafficking as it relates to women and
Prevent, Suppress and Punish Trafficking in Persons, Especially
girls trafficked into and within the United States. Although we
Women and Children (United Nations, 2000): 4
2
(a) “Trafficking in persons” shall mean the recruitment,
[in] parts of the middle East and Africa where old systems
transportation, transfer, harbouring or receipt of persons,
continue into modern times; children held in the worst forms
by means of the threat or use of force or other forms of
of forced labor; and in the trafficking and exploitation of
coercion, of abduction, of fraud, of deception, of the abuse
women for domestic and commercial sexual purposes.
of power or of a position of vulnerability or of the giving or
receiving of payments or benefits to achieve the consent of
a person having control over another person, for the purpose
of exploitation. Exploitation shall include, at a minimum, the
Report of the Task
exploitation of the prostitution of others or other forms of
Force on Trafficking
sexual exploitation, forced labour or services, slavery or prac-
of Women and Girls
tices similar to slavery, servitude or the removal of organs;
In the United States, the TVPA (and its reauthorizations and
amendments) provide tools to combat human trafficking. 5 The act
authorized the annual publication of the Trafficking in Persons
Report (TIP Report) and established the President’s Interagency
Task Force to Monitor and Combat Trafficking in Persons to assist
in the coordination of anti-trafficking efforts. The Trafficking
Victims Protection Reauthorization Act of 2003 (TVPRA) required
(b) The consent of a victim of trafficking in persons to the
the U.S. Department of State to collect data provided by foreign
intended exploitation set forth in subparagraph (a) of this
governments on trafficking investigations, prosecutions, convic-
article shall be irrelevant where any of the means set forth
tions, and sentences to determine compliance with the TVPA’s
in subparagraph (a) have been used;
minimum standards for the elimination of trafficking.
(c) The recruitment, transportation, transfer, harbouring or
Several federal departments address trafficking both within and
receipt of a child for the purpose of exploitation shall be
outside of the country. The U.S. Department of Justice Office for
considered “trafficking in persons” even if this does not
Victims of Crime and the U.S. Department of Health and Human
involve any of the means set forth in subparagraph (a) of
Services Office of Refugee Resettlement oversee victim services.
this article;
The U.S. Department of Justice is responsible for investigating
(d) “Child” shall mean any person under eighteen years of age.
Human trafficking has been referred to as “modern slavery,”
“modern-day
slavery,” and “contemporary slavery” by U.S. govern-
and prosecuting cases with the assistance of the U.S. Department
of Homeland Security and the U.S. Department of Labor (DOL).
For example, the DOL may assist by calculating back pay as
part of restitution for victims of trafficking. Additionally, the
ment officials, including President Barack Obama (Sweet, 2012;
DOL Office of the Inspector General investigates visa fraud and
White House, 2012), former Secretary of State Hillary Clinton
abuse, as well as other criminal threats to the integrity of its
(U.S. Department of State, 2012a), Ambassador Luis CdeBaca
Foreign Labor Certification (FLC) programs. 6 Evidence of human
(U.S. Department of State, 2012a), and others (e.g., Bales, 1999;
trafficking may be identified in the course of these investiga-
Batstone, 2007). These terms are used to contrast the illegal and
tions (U.S. Department of State, n.d.).
hidden nature of human trafficking in the 20th and 21st centuries
with the legal institution of slavery that existed historically.
O. Patterson (2011), on the other hand, argued that some forms
of human trafficking are much closer to the historical model of
slavery than Bales’s (1999) analysis suggests and thus should be
categorized as slavery rather than “modern slavery.” Patterson
(2011, p. 17) stated:
The context of slavery in our globalized world today may be
different, but an abundant and growing body of evidence
from observers and from enslaved women themselves clearly
show [sic] that this mode of domination is personally experienced in almost exactly the same way by today’s slaves as
the slaves of yesterday. Classic slavery persists, however,
mainly among three groups of persons: those cases … 14
The TVPA distinguishes between trafficking in persons for labor
and for commercial sex. This distinction can facilitate communication among agencies investigating and prosecuting cases under
federal law. However, it runs the risk of oversimplifying the complexity of human trafficking, because trafficked women and girls
may be subjected to both forced labor and sexual exploitation.
U.S. courts have ruled on cases in which women and girls have
been trafficked into nail and hair salons (U.S. v. Akouavi Kpade
Afolabi, 2009; U.S. v. Lynda Dieu Phan, Justin Phan, Duc Cao
Nguyen, 2009), the agricultural industry (U.S. v. Jose Tecum,
2001), domestic servitude (U.S. v. Calimlim, 2006; U.S. v.
Theresa Mubang, 2004), the service industry (U.S. v. Abrorkhodja
Askarkhodjaev, 2011), the garment industry (U.S. v. Kil Soo
Lee, 2001), fraudulent marriage (U.S. v. Lynda Dieu Phan, Justin
Sex Trafficking
the interpersonal relationships,
“Fernanda”
Introduction
social institutions and organizations, communities, and
Fernanda was an undocumented adult woman from South America who was smuggled through
public policy environments in
Mexico and into the United States. She had paid thousands of dollars in exchange for entry into the
which an individual acts.8 This
country and the promise of a job as a maid. Instead, she was forced into prostitution in the suburb
model suggests that success-
of a major city in the southeastern United States. Some of her earnings were confiscated by the
ful approaches to preventing
traffickers, and she was controlled by the threat of informing her family that she was a prostitute.
human trafficking need to take
The traffickers were from the same nation as Fernanda but had been living in the United States.
into account more than the
(From the Human Trafficking Law Project Database, 2013, Ann Arbor, MI: University of Michigan Law School. Copyright 2014 by the Regents of the
vulnerabilities of individual
and Overview
women and girls and consider
University of Michigan. Adapted with permission.)
the institutional structures,
Phan, Duc Cao Nguyen, 2009), and peddling (U.S. v. Adriana
social norms, and policy factors that can empower those individu-
Paoletti-Lemus, 1998). Women and girls also have been forced
als or constrain individual agency and options.
into prostitution (U.S. v. Marcus Sewel, 2007), stripping (U.S. v.
Corey Davis, 2008), pornography in its many forms (U.S. v. Irey,
LITERATURE REVIEW
2007), and sex tourism (U.S. v. Kent Frank, 2007). 7
The task force identified literature pertaining to the trafficking
The case examples provided throughout this report are intended to
illustrate the variation in human trafficking of women and girls in
the United States, as well as to highlight some determinants of and
responses to trafficking. Examples include testimonials as well as
fictional characters based on genuine trafficking experiences and
cases. The examples are intended to realistically represent patterns
of trafficking in the United States. Cases were developed to
illustrate labor and sex trafficking, variations in age of victims and
of women and girls into and within the United States published
between 1980 and December 31, 2012. Although the term human
trafficking was not used in the peer-reviewed literature prior to
the 1990s in the United States, some of the seminal research on
the prostitution of minors—which is human trafficking according to the TVPA—was published in the 1980s. 9 We believe it is
essential to include studies that examined the populations of
interest, even if the work predated the current terminology.
survivors, geographic and demographic variation, different means
The task force relied on nonempirical reference materials for the
of trafficking, and variation in risk factors and outcomes.
history, legal framework, and background information on this topic.
These included academic sources; reports and briefs from governmental, intergovernmental, and nongovernmental organizations;
Methodology
and case information from databases maintained by the University
FRAMEWORK
However, information regarding prevalence of human trafficking
A social ecological model is used as the framework for this
from nonempirical sources was reported only as evidence of varia-
report, highlighting the contributions of individual, interpersonal,
tion in official estimates, not as empirically confirmed data.
institutional, community, and societal factors as they pertain to
human trafficking. Social ecological models locate individuals
with their unique identities, experiences, strengths, vulnerabilities,
and characteristics at the center of a series of concentric circles
representing multiple levels of social influence that independently
and interactively impact their options, behaviors, and outcomes
(McLeroy, Bibeau, Steckler, & Glanz, 1988). Social ecological
models are predicated on the assumption that behaviors and
outcomes are multiply determined; intrapersonal characteristics
are one part of the picture, but consideration must also be given to
15
of Michigan Law School and the U.N. Office on Drugs and Crime.
Because this is a relatively new research area, there are a
limited number of published empirical studies, especially on
trafficking into and within the United States and on labor
trafficking. We cast a wide net to capture all relevant research,
capitalize on the unique contributions of multiple methodological approaches, and determine which findings are supported
by converging evidence from multiple approaches. Thus, the
review included studies using qualitative, quantitative, or mixed
methodologies; large or small sample sizes; and case studies,
ethnography, and community-based participatory research,
among other approaches. Each methodological approach offers
Additionally, task force members deliberated over the variety of
a unique lens and contributes to a more complete picture of
existing terminology used to describe commercial sex activity. In
human trafficking.
the end, we settled on a particular set of terms that best reflect
The task force sought high-quality empirical research and defined
this as work in which (a) the methodology is appropriate for the
research question, (b) the selected sample is appropriate for the
questions asked and the sampling methods are clearly explained,
Report of the Task
Force on Trafficking
of Women and Girls
(c) measures and methods are fully and clearly explained, (d) limitations are addressed, and (e) conclusions and inferences drawn
are appropriately supported by the qualitative or quantitative data.
In other words, whether qualitative or quantitative techniques are
used, the methodology should be transparent, and the evidence
should support the conclusions. Key characteristics of the empirical studies identified are presented in a set of grids available as
supplementary material online.10
the population of concern: trafficked women and girls. The term
commercial sexual exploitation (CSE) was used to encompass all
forms of involvement in the commercial sex industry as a result of
trafficking (force, fraud, coercion) or of exploitation of vulnerability
(e.g., homelessness, poverty, disability, gender nonconformity).
The term commercial sexual exploitation of children (CSEC) was
used when the victim of such exploitation was a minor (17 years of
age or younger under U.S. law). The terms sex work and sex worker
were avoided, as they imply voluntary activity and the focus of
this report is on trafficked individuals. The terms prostitution and
prostitute were similarly avoided unless using CSE would inhibit
clarity or alter the meaning of the literature reviewed.
The accumulated evidence provides a valuable foundation for
CONCEPTUAL CHALLENGES
addressing the trafficking of women and girls, but additional work
Research and practice related to human trafficking are challeng-
is needed. Policy and programmatic responses to human trafficking
ing due to the complexity of the issue. Throughout this docu-
are based on the evidence available at the time they were enacted.
ment, the task force presents case examples of women and girls
Ultimately there is a need for stronger policy based on a longitudi-
trafficked into or within the United States. Although there are
nal and population-based assessment of the scope, characteristics,
commonalities—their gender and the presence of exploitation—
risk and protective factors, and impact of human trafficking.
the truth is that there is no typical case of human trafficking.
The diversity of circumstances is vast. To establish laws, develop
LANGUAGE CONSIDERATIONS
policy, conduct research, provide services, and communicate
One of the biggest challenges faced by the task force was
about this issue, experts must categorize and define types and
determining how to use appropriate and accurate language to
subtypes of trafficking. Research in social and cognitive psy-
synthesize the experiences of trafficking victims described in
chology demonstrates that labels, categories, and schemas can
the literature. The range of experiences that trafficked women
facilitate information processing (Fiske & Linville, 1980; Fiske &
face—from blatant and overt violence, to subtle yet very
Taylor, 1991; Schank & Abelson, 1977), but these same cognitive
effective coercion tactics—makes this an enormously complex
shortcuts can hinder full understanding and careful processing
topic. For example, we deliberated over the detail with which the
of complex and nuanced realities (Chanowitz & Langer, 1981;
violence perpetrated against trafficked women and girls should
Langer, 1990; Langer & Abelson, 1974). Humans make relatively
be described. There was an obligation to represent honestly
swift, unconscious, and automatic categorizations of other
the experiences of victims and survivors while striving to avoid
people and their behaviors (Fiske & Taylor, 1991). However,
sensationalism and voyeurism on the one hand and sanitization
the category label may impede attention to and processing of
on the other. Furthermore, emphasizing the very real physical and
additional information, consideration of alternate possibilities, or
mental violence perpetrated in trafficking may inadvertently rein-
deeper investigation. In instances of human trafficking, this may
force misperceptions. Trafficked women and girls who experience
reduce the chances that a victim will be identified. It is import-
less overtly brutal circumstances may not be seen as legitimate
ant not only for psychologists in therapeutic, research, policy,
victims of trafficking and may not receive the justice they
or educational settings to guard against premature conclusions
deserve. It is hoped that the resulting report gives an accurate
about people or their behavior but also to use the research
picture of the issue.
to assist other professionals to avoid hasty—and potentially
injurious—conclusions.
16
The U.N. Office on Drugs and
Sex Trafficking
“Lot Lizards”
Introduction
Crime (2011) acknowledged
that smuggling and trafficking
A law enforcement officer attending training on human trafficking stated there were no incidents of
are frequently confused and
this crime in the county. Because a major interstate bisected the county, the trainers asked about
that the terms sometimes are
the possibility of juveniles being prostituted at truck stops and travel plazas. The officer responded
used interchangeably, even
that there were “lot lizards” at [name of travel plaza] but denied encountering human trafficking.
in the research literature.
“Lot lizard” is a pejorative, slang term referring to individuals—female or male—exchanging sex
Unlike smuggling, which
for money or something else of value at truck stops, fueling plazas, or rest areas.
requires movement across an
(D. L. Hume, personal communication, September 28, 2012. Used with permission.)
international border, human
and Overview
trafficking does not require
Another challenge arises from the overlap of human trafficking
with other closely related crimes, such as human smuggling,
prostitution, and intimate partner violence (IPV). Trafficked
women and girls frequently are victims of multiple crimes. It is
possible that there are trafficking victims within a variety of
clinical populations.
A number of authors highlight similarities in the underlying
risk factors, processes, and consequences of IPV and trafficking (Alejano-Steele, 2011; Hynes & Raymond, 2002; Moe, 2004;
Owens Bullard, 2011; Reid, 2010; Zimmerman et al., 2003).
Although they can be, they are not necessarily mutually exclusive.
For example, sex trafficking and IPV may occur in relationships in
which a boyfriend or spouse is also the woman’s pimp; labor and
sex trafficking as well as IPV may occur within “mail order bride”
arrangements (Hynes, 2002). Batterers and traffickers perpetrate similar types of violence (Farley et al., 2003; Giobbe, 1993;
Hopper & Hidalgo, 2006), and because of the complex coercion
methods that traffickers use, it may not be clear to the trafficking survivor herself that she is a victim (Shigekane, 2007).
any movement of the victims;
individuals can be trafficked in a single locality, including within
their own home. As illustrated in Table 1 (see page 18), smuggling and trafficking are two distinct crimes, although they can
co-occur (Webber & Shirk, 2005). Above all, trafficking involves
exploitation of a human victim; exploitation or victimization is not
a defining element of smuggling (K. Kim & Hreshchyshyn, 2004).
Probably the most contentious area of overlap and attempted
distinction is between sex trafficking and prostitution. Complex
discourse about prostitution, sex work, exploitation, and sex
trafficking abound. O’Connell Davidson (2006) noted that in the
absence of clearly articulated and agreed upon definitions of
concepts such as exploitation, there is disagreement about when
prostitution is sex trafficking. Some scholars have argued that
prostitution is a legitimate and potentially empowering choice of
work (e.g., Brennan, 2002; Butcher, 2003; Foerster, 2009; Weitzer,
2010) and have distinguished it from sex trafficking, which
involves force or deceit. 11 They argue that criminalization of prostitution denies individuals the right to freely control their own
bodies and sexuality and support themselves as they wish. Other
One area of human trafficking facilitated through intimate
scholars argue that prostitution itself is an act of violence and
relationships includes situations involving mail-order brides.
inherently harmful (Barry, 1979; Farley et al., 2003; MacKinnon,
Although marriage brokerage is a lucrative and legal enter-
2005; Raymond, 2004); they argue that consent and choice are
prise in many countries (with an estimated 10,000 Internet
meaningless when there are no real alternatives.
sites worldwide), the relational context of marriage may hide
instances of human trafficking. An estimated 2,000–3,500
American men find their wives through mail-order bride agencies each year, particularly from Southeast Asia and the former
Soviet Union (Hughes & Roche, 1999; Hynes, 2002). Although
not every situation involves trafficking, marriage brokerage
provides an opportunity to lure women from abroad for potential
CSE or domestic servitude.
Agency to choose prostitution must be considered in the context of
social oppressions based on gender, race, and class. According to
Farley (2006), “prostitution is ‘chosen’ as a job by those who have
the fewest real choices available to them” (p. 110). For the purposes of this report, the task force acknowledges this controversy
because of its importance in the discourse on human trafficking.
However, this debate does not refute the fact that trafficking
occurs in prostitution and other sex work (D. Banks & Kyckelhahn,
2011; Barnitz, 2000; Lloyd, 2011; Pierce, 2009; Zimmerman et al.,
17
2008) and that many women and girls in the sex industry work
under horrific conditions (Peng, 2005). The research provides
compelling evidence that prostitution is not, in fact, victimless;
the harmful consequences for body and psyche are well-documented and summarized in a later section of this report (L. M.
Baker, Dalla, & Williamson, 2010; Burnette et al., 2008; Choi,
Klein, Shin, & Lee, 2009; Dalla, Xia, & Kennedy, 2003; Farley &
Barkan, 1998; Farley et al., 2003; Jung, Song, Chong, Seo, & Chae,
Report of the Task
2008; McClanahan, McClelland, Abram, & Teplin, 1999; Mitchell,
Force on Trafficking
Finkelhor, & Wolak, 2010; Potterat et al., 2004; Sallman, 2010; K.
of Women and Girls
Shannon et al., 2008; Stachowiak et al., 2005; Thukral, 2005).
TABLE 1
Human Trafficking vs. Migrant Smuggling
ACTION
HUMAN TRAFFICKING
MIGRANT SMUGGLING
“Recruitment, transportation, transfer, “The facilitation, transportation, attempted
harbouring or receipt of persons.” a
across an international border.” b
Transnational border crossing
Not required
Required
Movement of target person
Not required
Required
Consent
If other elements of definition present, Required
consent not relevant; not relevant for minors. Outcome
Economic exploitation of the individual that may
include sexual exploitation and/or forced labor.
Source of profit
Trafficker profits through exploitation of victim
Smuggler profits in payment for assisting
in forced labor/commercial sex.
illegal entry.
Victimization Required; crime is against a person, Not required. Arrangement may be mutually
violation of human rights.
beneficial. c Crime is against the state rather
Illegal border crossing; illegal entry into a nation.
than a person.
Crime Crime is against the state.
Crime is against a person.
a
U.N. Protocol (2000).
b
U.S. Department of State, Human Smuggling and Trafficking Center (2006).
c
transportation, or illegal entry of a person
Although smuggling does not require victimization, there are occasions when these two
phenomena do overlap. Human trafficking is sometimes the end result of a smuggling
agreement, either through exploitation directly by the smuggler or by smugglers working in
concert with traffickers and pimps. According to U.S. federal law, however, the initial consent
of a person to be smuggled into the country does not preclude charges of human trafficking
if force, fraud, or coercion is then used to exploit the individual.
18
MEASURING HUMAN TRAFFICKING
Human trafficking as a crime, including its embedded human
In addition, many of the contexts in which trafficking occurs
rights violations, is extremely difficult to measure. Because of
are relatively unobserved, such as migrant labor, domestic
numerous challenges, there is incomplete and imperfect knowl-
servitude, or the commercial sex industry (Bauer, 2007; Farrell
edge about the nature and scope of the problem, the character-
et al., 2012; Human Rights Watch, 2001; Silverman, 2011).
istics of both victims and traffickers, and the effectiveness of
Farrell et al. (2012) reported that of 140 cases of labor and sex
policies and practices used to respond to trafficking.
trafficking investigated in 12 U.S. counties, 43% occurred in a
private residence, making detection difficult. Persons trafficked
in the service sector (e.g., hotel cleaning staff, restaurant staff)
Methodological Challenges
may interact briefly with patrons of those businesses; however,
The methodological challenges and the resultant research gaps
actions, as well as potential language barriers, render trafficked
are outlined in a number of reports and reviews (Brennan, 2005;
persons in the service sector virtually invisible.
Clawson, Dutch, Salomon, & Goldblatt Grace, 2009; Clawson,
Layne, & Small, 2006; Goodey, 2008; Gozdziak & Bump, 2008;
Jahic & Finckenauer, 2005; Laczko & Gozdziak, 2005; Oram,
Stöckl, Busza, Howard, & Zimmerman, 2012; Tyldum, 2010; van
der Laan, Smit, Busschers, & Aarten, 2011; Weiner & Hala, 2008;
Zhang, 2009). The first and perhaps largest challenge is the
hidden nature of the crime. This is due in part to the nature of
criminal activity; trafficking is clandestine (Clawson, Layne, &
Small, 2006; Jahic & Finckenauer, 2005), and not all incidents
are discovered or reported. This makes acquisition of a representative sample impossible, as there is no defined population or
sampling frame.
genuine connections are rare. Infrequent and impersonal inter-
Lack of a comprehensive centralized database of human trafficking cases further complicates research efforts. The absence
of such a database arises in part because of a lack of information sharing among multiple agencies (law enforcement, human
services, education, the judiciary) at multiple levels (local,
state, federal), sometimes due to statutory or policy restrictions
(Farrell et al., 2010, 2012; Hopper, 2004; Reid, 2010). 1 Variation
in charges filed and disposition of cases further complicate the
availability of reliable data. Variations can result if trafficked
persons deny their victimization and thus are not counted (L.
A. Smith, Vardaman, & Snow, 2009) or if victims refuse to
cooperate in the prosecution of traffickers because of fear or
of trafficking victims and
Labor Trafficking
“Rayya”
Report of the Task
survivors, and insufficient
evaluation of anti-traffick-
Rayya was a 10-year-old girl from the Middle East forced into domestic servitude by a wealthy family
ing policies and programs.
in the western United States who was also from the Middle East. The family used accusations and
Gozdziak and Bump (2008)
threats of police action to coerce Rayya’s family to sell her. Using a fraudulently obtained visa, the
reviewed 1,467 articles and
wealthy family brought Rayya to their home and forced her to do housework, provide child care, and
determined that only 39 were
cook and to live in the garage. Rayya was unpaid, verbally and physically abused, and prevented
based on empirical research,
from attending school or religious services.
although 96 nonempirical
(From the Human Trafficking Law Project database, 2013, Ann Arbor, MI: University of Michigan Law School. Copyright 2014 by the Regents of the
studies were published in
Force on Trafficking
of Women and Girls
peer-reviewed journals. The
University of Michigan. Adapted with permission.)
nonempirical articles largely
intimidation (Farrell et al., 2012; Gajic-Veljanoski & Stewart,
relied on overviews, commentaries, and anecdotal information.
2007). The difficulties are compounded when trafficking is
Likewise, in a meta-analysis of intervention programs, van der
misidentified as delinquent or criminal behavior or as undocu-
Laan et al. (2011) concluded that policies or interventions to
mented immigration (Barnitz, 2001; Laczko & Gozdziak, 2005;
prevent or suppress cross-border trafficking for the purpose of
Lloyd, 2005; Mitchell et al., 2010; L. A. Smith et al., 2009;
sexual exploitation have not been evaluated rigorously enough
Srikantiah, 2007; Reid, 2010; Webber & Shirk, 2005; Williams,
to determine their effect.
2010).
Researchers are further challenged by the sheer diversity of
trafficking situations and experiences (Brennan, 2005) and the
conceptual challenges mentioned previously. There is no typical
trafficking scenario, making it difficult to extract common
elements and create useful generalizations. Variations in how
terms are operationally defined further complicate a cohesive
understanding of trafficking, traffickers, ancillary participants,
and the victims involved.
Prevalence and Incidence
Because of the many methodological challenges, there is
currently no reliable estimate of the prevalence and incidence
of trafficking of women and girls in the United States. What
is known is largely based on criminal justice statistics that
underestimate the extent of the problem because of underreporting, misidentification, and decisions not to pursue investigation
An additional challenge is access to persons with experiential
or prosecution (Clawson, Layne, & Small, 2006; Mitchell et al.,
knowledge of the phenomenon. Victims who are still in trafficking
2010). Underreporting, misidentification, and decisions not
situations will rarely be accessible to researchers, and attempt-
to pursue cases may be differentially applied on the basis of
ing to access them can prove dangerous for the victims and the
victims’ characteristics, including race, sexual orientation, or
researchers (Zimmerman & Watts, 2003). Continued access may
immigration status. This in turn could impact the demographic
be complicated by movement for safety reasons or by removal
makeup of the population of identified victims. Therefore,
from the country. Survivors may not be psychologically ready to
although criminal justice statistics provide a basic understand-
be interviewed or may be protected from contact with researchers
ing of some characteristics of trafficking in the United States,
to protect confidentiality or to protect investigations (Laczko &
they must be interpreted cautiously.
Gozdziak, 2005). Key informants in law enforcement, prosecutors’
offices, and service agencies may be unable or unwilling to share
information regarding work with trafficked women and girls.
Kyckelhahn, Beck, and Cohen (2009) examined 1,229 investigations
of suspected human trafficking in the United States reported by
federally funded task forces between January 2007 and September
As a result of these challenges, gaps and weaknesses exist in
2008. Of these, 112 incidents were confirmed, 286 were deter-
the empirical research on trafficking (Freedom Network, 2010),
mined not to be trafficking, and 831 were pending or undetermined
including an absence of research on labor trafficking relative
at the time the report was submitted. For confirmed cases that
to sex trafficking, too little research representing the viewpoint
provided gender information, roughly 99% of sex-trafficking
20
Measuring Human
Trafficking
victims (out of n = 230) and 61% of labor-trafficking victims
estimates are themselves indicative of the difficulty in getting
(out of n = 36) were women. For confirmed cases that provided
a handle on prevalence and incidence (DeStefano, 2007).
citizenship information, 34% of sex-trafficking victims were
As Goodey (2008) wrote, the published estimates of human
U.S. citizens, nationals, or permanent residents. For confirmed
trafficking are often unverifiable, a problem common to serious
cases that provided citizenship information (n = 216), 34% of
and organized crime. There are no estimates related to the labor
sex-trafficking victims were U.S. citizens, nationals, or perma-
trafficking of adult or child citizens within the United States,
nent residents.
and only rough extrapolations were made of the number of
Mitchell et al. (2010) estimated approximately 1,450 detentions
and arrests were related to prostitution of minors in the United
States in 2005. 2 The authors emphasized that due to methodological issues, as well as the realities of the criminal justice system
(e.g., underreporting, misidentification, and decisions not to pursue investigation or prosecution), this number underestimates the
number of juveniles exploited in commercial sex. These researchers
examined 138 of the cases in greater depth and determined that
57% involved a third-party exploiter (pimp, trafficker); 31% were
“solo” cases in which there was no intermediary exploiter; and
12% were atypical cases in which the minor was paid for sexual
activity by a family member, a caretaker, or an acquaintance but
was not “prostituted” in the sense of multiple clients. The authors
stressed that within each of these subcategories, there was a
great deal of variation regarding the exploiters (organized networks
vs. individual operations, including family members), the youth’s
circumstances (homeless, runaway, living at home, or in foster
care), and other factors. In cases examined by Mitchell et al.,
59% of victims were White, 36% Black, and 6% “other” or “do not
know.” Nine percent identified as Hispanic ethnicity.3
Mitchell et al. (2010) also noted that law enforcement responses
differed depending on whether the youth was identified by police,
in which case the youth was more likely to be treated as delinquent, or by a concerned party, in which case the youth was more
likely to be treated as a victim. The authors of this exploratory
study cautioned that a more nuanced understanding of these
issues is necessary, as the stereotypical runaway trafficked by a
pimp fails to capture the variability in this population.
The U.S. Department of State initially suggested that approximately 50,000 individuals were trafficked into the United States
each year (Miko & Park, 2002). This number was decreased
to 18,000–20,000 in the 2003 Trafficking in Persons Report
(TIP Report; U.S. Department of State, 2003). The number was
reduced once again to 14,500–17,500 individuals trafficked
into the United States each year in the 2005 and 2006 TIP
reports (U.S. Department of State, 2005, 2006). These shifts in
21
minors at risk for sexual exploitation. Therefore, caution must
be exercised in citing published statistics. Jordan (2011) argued
that the continued use of unreliable and unsubstantiated estimates of trafficking numbers leads to ineffective policy and
public skepticism regarding the reality of human trafficking.
RISK FACTORS FOR THE TRAFFICKING
OF WOMEN AND GIRLS
Vulnerability to human trafficking results from a nesting of an
individual’s characteristics and personal history within a complex and dynamic system of external factors. It is a system that
Societal and Public Policy
Risk Factors
encompasses many layers: the immediate social situations and
Numerous local, national, and global processes contribute to the
relationships in which an individual is embedded; the character-
trafficking of women and girls in the United States. Although
istics of school and work settings; the local community in which
selected factors are addressed individually in the following sec-
that individual lives; and national patterns of economics, policy
tions, they are interconnected in a network of determinants that
decisions, and societal forces that impact the local community.
amplify the risk of human trafficking.
All of these layers are further influenced by current processes of
globalization and transnational policies. 1 These factors, from the
GENDER OPPRESSION, GENDER-BASED VIOLENCE, AND A
individual to the global, play out within an immediate and histor-
CULTURE OF TOLERANCE FOR SEXUAL EXPLOITATION
ical milieu of oppressions on the basis of gender and sexuality,
Gender oppression takes many forms that independently and col-
race and ethnicity, social class, and other identities.
lectively contribute to individuals’ vulnerability to trafficking and
Vulnerability to trafficking must be understood at multiple levels.
Consideration must be given to the particular combination of
factors that determine whether one girl or one woman is at risk
of exploitation and also to factors that lead to heightened risk for
specific groups and populations. Understanding these contributing factors provides the best hope of identifying potential points
of intervention to prevent the trafficking of women and girls and
to redress the harm that it has caused its victims.
hinder societal recognition of exploitation. Gender inequities persist in control of assets and in earning power both in the United
States and in other nations (United Nations Population Fund,
n.d.; U.S. Department of Commerce & Office of Management and
Budget, 2011). Work traditionally performed by women continues
to be devalued and poorly paid. Worldwide, women are more likely
to live in poverty than are men, and women in many nations face
barriers to education, voting rights, and property rights.
In addition, “gender-based discrimination intersects with discriminations based on other forms of ‘otherness,’ such as race, ethnicity,
religion, and economic status, thus forcing the majority of the
Risk Factors for the
Trafficking of Women
and Girls
world’s women into situations of double or triple marginalization”
GLOBALIZATION
(Coomaraswamy, 2000, pp. 19–20). Gender-based discrimination
Numerous authors argue that processes related to globalization and
also intersects with discrimination based on disability, sexual
international policies exert a major influence on human trafficking
orientation, age, and gender identity. All of these intersections
(APA, Presidential Task Force on Immigration, 2012; Bales, 1999,
exacerbate individual vulnerabilities and societal denial of exploita-
2003; Chuang, 2006; Danailova-Trainor & Belser, 2006; Enriquez,
tion (Hynes & Raymond, 2002; Tang & Lee, 1999; Tharinger, Horton,
2006; Louie, 2001; Meyer, 2003; Othman, 2006; Santos, 2002;
& Millea, 1990; Ugarte, Zarate, & Farley, 2003).
Seabrook, 2001). These characteristics and changing patterns
In addition to being a violation of basic human rights, genderbased violence manifests and maintains the inequality of women
and girls (United Nations, 1993). Victims of both labor trafficking and CSE experience elevated levels of physical and sexual
violence (Freedom Network, 2010). Furthermore, past experience
of violence and abuse increases the risk of being trafficked
(Bagley & Young, 1987; Boxill & Richardson, 2005; McClanahan
et al., 1999; Pierce, 2009; Reid, 2011; Simons & Whitbeck, 1991;
Tyler, Whitbeck, Hoyt, & Yoder, 2000; Van Dorn et al., 2005).
Decades of psychological research demonstrate the sexualization
and objectification of women and girls (APA, Task Force on the
Sexualization of Girls, 2010; Fischer, Vidmar, & Ellis, 1993;
Frederickson & Roberts, 1997; Hughes, 2000; Kaschak, 1992;
impact human trafficking in complex ways. For example, Seabrook
(2001) argued that because of high debt, many poverty-affected
countries are subject to structural adjustment programs as a
condition of assistance through the International Monetary Fund.
These programs encourage less state spending on national welfare,
health, nutrition, and education and greater acceptance of “open
market” policies, resulting in three outcomes that increase risk of
human trafficking:
• Vulnerable populations are most affected by cuts in
social programs.
• More family members are forced into the labor market.
• Children become more economically marginalized.
Quina & Carlson, 1989). Human trafficking—in particular sex
These shifts in economic policy can contribute to human trafficking
trafficking—occurs within the context of widespread objectifica-
by forcing rural populations to seek work in urban areas or abroad,
tion and commodification of the female body that creates women
removing them from family and community protection (Hynes &
and girls as “product” in economies in which they have little
Raymond, 2002; Seabrook, 2001). To finance relocation, individuals
power and sometimes few options for self-sufficiency. In both
often take out loans that push them into debt and increase their
labor and sex trafficking, “there is a power imbalance where the
vulnerability. Compounding individuals’ vulnerability, countries
trafficker possesses the economic power to treat another human
must apply most of their monetary assets to debt payments rather
as a commodity and to keep the profits. There is no element of
than to anti-trafficking (Bales, 2003) or anti-poverty (Farmer,
consent, voluntariness, pleasure or personal desire of the victim
1999) efforts.
in this transaction” (APA, Division 35, Special Committee on
Violence Against Women, n.d., p. 14).
The number of those who—driven by poverty and persecution, displaced by environmental catastrophes and political instability and
Research in four countries with major commercial sex mar-
conflict, or pulled by promises of employment, liberty, or a better
kets (Jamaica, the Netherlands, the United States, and Japan)
life—voluntarily and involuntarily migrate is at one of the highest
suggests that each of these countries maintains a culture of tol-
levels ever recorded (APA, Presidential Task Force on Immigration,
erance for sexual exploitation that supports sex-trafficking oper-
2012; United Nations Department of Economic and Social Affairs,
ations (Shared Hope International, 2007). In the United States,
2009; United Nations High Commissioner for Refugees, 2010;
the glamorization of pimping and prostitution and the sexualiza-
United Nations Population Fund, 2009). In the United States, there
tion of adolescent girls in popular culture may further contribute
are nearly 40 million foreign-born persons, which is the largest
to a climate of risk (APA, Task Force on the Sexualization of Girls,
number recorded to date (Grieco et al., 2012).2
2010; Kotrla, 2010).
Although migration has always been part of the human experience,
the face of migration has changed. Changes in the labor market
as a result of globalization led to an increased number of women
migrating to support their families (APA, Presidential Task Force
23
Labor Trafficking
These programs include visas
“Jennifer”
for domestic servants (A-3,
G-5, and B-1 visas) and
Jennifer, a 30-year old Guatemalan woman, came to the [United States] … with the dream of
visas for agricultural and
providing her two children with a good education and her ailing mother with proper medical atten-
nonagricultural temporary
tion. … She learned about a job working as a waitress at a restaurant in Virginia. … At first the
seasonal workers (H-2A and
restaurant owner and staff were welcoming. Because Jennifer had nowhere to live, the restaurant
H-2B visas; frequently called
owner allowed her to sleep in a room at the back of the restaurant in exchange for a very low wage.
“guest workers”). 3 Workers’
Report of the Task
However … within two months the owner fired the cook and the other waitress. Jennifer was coerced
legal status in the United
Force on Trafficking
into working 14-hour shifts every day, preparing the food, cleaning the restaurant and serving
States depends on their
patrons. Jennifer felt she had no other choice because she did not have a support network to turn to
remaining in the employment
and was not able to communicate well in English. She was in this situation for 8–9 months until one
situation associated with
day during an undercover operation at the restaurant she was able to ask for help from the police
their initial entry, even if the
officers. Jennifer explained her situation … including the constant verbal and psychological abuse
situation is abusive or exploit-
by the restaurant owner.
ative (American Civil Liberties
(From Testimony of Mary C. Ellison, J.D., Director of Policy, Polaris, Before the Tom Lantos Human Rights Commission, International Human
Union, 2007; American
Trafficking and Forced Labor, November 28, 2012, Washington, DC: Polaris. Copyright 2014 Polaris. Reprinted with permission. Names, locations, and
University Washington College
of Women and Girls
other identifying information have been changed and/or omitted to preserve the confidentiality of the populations Polaris Project serves.)
of Law International Human
Rights Law Clinic & Centro de
on Immigration, 2012; Piper, 2003; Zimmerman, Kiss, & Hossain,
los Derechos del Migrante, 2010; Bauer, 2007; Bauer & Ramírez,
2011). According to the International Organization for Migration
2010; Global Workers Justice Alliance, 2012; Human Rights
(2010), at least 49% of the worldwide migrant population today
Watch, 2001; Polaris Project, 2011b, 2012).
is female. Female migrants seek a variety of jobs; however, most
employment opportunities available to them are relatively lowpaying, low-skilled, and low-power jobs, frequently characterized
by traditionally feminine roles of nurturing and serving (Santos,
2002). The sectors of the U.S. economy in which female migrants
are employed are also those in which human trafficking has most
frequently been identified: the service sector (e.g., hotels, restaurants, salons), domestic service (e.g., nannies, housekeepers),
nursing homes and home health care, agriculture and agricultural
processing, the garment industry, and sex work (Clawson et al.,
2009; Polaris Project, 2011b, 2012; see also the Human Trafficking
database at the University of Michigan School of Law [Human
Trafficking Law Project, 2013]). Hynes (2002) noted that
transnational sex trafficking in women has a distinct pattern of women being trafficked from developing countries
(Asia, Latin America, and Africa) and new market economies
in crisis (Russia, Ukraine, and other former Soviet countries) to so-called developed countries, including Western
Europe, Australia, Japan, the U.S. and Canada . (p. 48)
Intensified enforcement of immigration law has pushed undocumented immigrants further underground, making them even more
vulnerable to exploitation (Brown, Hotchkiss, & Quispe-Agnoli,
2008). Some advocacy groups suggest that immigrant communities are relatively closed to outsiders because members fear their
own or others’ deportation, inadvertently protecting gangs and
small criminal networks that prey on vulnerable members of their
own group (Shared Hope International, 2007). There is also some
evidence that more stringent border controls simply moved the
point of crossing for illegal entrants to more dangerous routes
through desert areas and that this change further endangers
migrant women when crossing illegally (Hendricks, 2007; Lozano
& Lopez, 2010).
Women migrating from Mexico without legal authorization are
more likely than men to use smugglers to cross into the United
States, which increases their risk of being trafficked for forced
labor or commercial sex (Donato & Patterson, 2006). Other
research on human trafficking from Mexico found that pimps
frequently work in concert with human smugglers to kidnap or
Several visa programs within the U.S. immigration system itself
trick women and girls as young as age 12 into crossing the U.S./
are under scrutiny by groups concerned about human trafficking.
Mexico border, where they are trafficked into commercial sex
24
in San Diego and surrounding military bases and rural areas
private business entities) creates a supportive environment for
(Hernandez, 2003; Ugarte et al., 2003).
human trafficking operations. Furthermore, when members of the
population perceive corruption to be high, they are more likely to
ECONOMIC INSTABILITY AND WIDESPREAD POVERTY
accept a trafficker’s claim that using a smuggler is essential to
Pervasive poverty in combination with limited access to employ-
obtain necessary travel documents (UNODC, 2011).
ment or other resources to meet basic needs has been identified
as a primary characteristic of source countries for human trafficking, immigration, and migrant labor (Aronowitz, 2009; Bales,
Risk Factors for the
2003, 2004; Danailova-Trainor & Belser, 2006; DeStefano, 2007;
Trafficking of Women
Farr, 2005; Newman, 2006; O’Neill Richard, 2000; Trujillo, 2004). 4
and Girls
The leading countries of origin for confirmed international
trafficking victims in the United States are also major source
countries for migrant workers and immigrants seeking entry to
the United States to raise themselves and their families out of
poverty (Farr, 2005; Free the Slaves & Human Rights Center,
2004; Gammage, 2002; U.S. Department of State, 2011b; Zhou,
2003). Research by the World Bank found that developing countries located closest to a major labor-receiving region such as
the United States or Europe have the highest rates of migration
(Page & Adams, 2003). Mexico is one of the primary countries of
origin for men, women, and children trafficked into the United
States (Free the Slaves & Human Rights Center, 2004; Shelley,
2010; Ugarte et al., 2003; U.S. Department of State, 2010).
SOCIAL AND POLITICAL INSTABILITY
An unstable political environment disrupts social functioning
and, by extension, exposes vulnerable women and children to
traffickers (Derks, 2000; Hughes, 2000, 2002; Joshi, 2002).
Examples from Somalia (Karama Movement, 2010), Haiti
(Delaney, 2006; U.S. Department of State, 2009), and post-
Both international and domestic gangs contribute to human trafficking. Gangs and smaller criminal enterprises operating within
and outside of the United States have increased their level
of cooperation with one another and with transnational criminal
organizations to create global trafficking networks that link
supply and demand in source, transit, and destination countries
(UNODC, 2011). In particular, gangs and criminal networks of
various nationalities have built upon their human smuggling
operations to traffic illegal migrants into forced labor and CSE
in the United States (Aronowitz, 2009; Free the Slaves & Human
Rights Center, 2004; National Gang Intelligence Center, 2011;
O’Neill Richard, 2000; Webber & Shirk, 2005). 5
WAR, CONFLICT, AND MILITARY PRESENCE
International research on human trafficking shows that environments impacted by armed conflict or war, the aftermath of war, and
military presence facilitate the sex trafficking of women (Hughes,
Chon, & Ellerman, 2007; Nikoli -Ristanovi , 2002b; United Nations
Development Fund for Women/UNIFEM, 2002). In locations where
large numbers of soldiers were stationed for long periods of time,
such as Vietnam, businesses involving CSE and CSEC became
core components of local “entertainment” and continued as sites
of exploitation of women and girls long after the soldiers returned
home (Barnitz, 2000).
Hurricane Katrina New Orleans (Fletcher, Pham, Stover, & Vinck,
Researchers also found that military men were recruited to act
2007; Kissinger et al., 2008) suggest that whether the instability
as escorts or false marriage partners to bring trafficked women
is the result of natural disasters, economic crises, or political
into the United States without inspection (in legal terminology,
conflict, the resultant lack of civil protections amplifies the risk
of trafficking for women and girls (CdeBaca, 2010).
“entry
without inspection”; O’Neill Richard, 2000). In their study
of prostituted women in the United States, Raymond and
Hughes’s (2001) sample included Asian-born respondents who
PERVASIVE CRIME AND CORRUPTION
had been prostituted in Asia. These women had been married
Environments characterized by widespread criminal activity and
to U.S. servicemen who then forced them into CSE after having
corruption contribute to the entire process of human trafficking,
brought them to the United States. Similarly, Shelley (2010)
including identification and recruitment of potential victims,
reported that women from Japan, Korea, and the Philippines
transport and exploitation of victims, and money laundering
who come to the United States as military brides are sometimes
(Trujillo, 2004; UNODC, 2011). Corruption among authorities at all
pressured into becoming part of the sex industry.
levels (local and national governments, law enforcement, military
forces, international and nongovernmental organizations, and
25
Other studies suggest militarism itself contains cultural ideals
about gender that increase the vulnerability of women to
trafficking through socioeconomic marginalization (Nikoli -
have little incentive to allot resources to investigations. According
Ristanovi , 2002a). When armed conflict, economic inequalities,
to their respondents, this is particularly problematic for garnering
and a growing demand for commercial sex intersect, sex traffick-
the necessary political will to address labor trafficking.
ing increases (Watts & Zimmerman, 2002).
CONFLICTING POLICIES
Contradictions between local and national laws or between policies from different government agencies regarding immigration,
Report of the Task
employment, prostitution, and other issues may reduce recognition
Force on Trafficking
of and responses to trafficking. Chacon (2006, p. 2) argued that
of Women and Girls
Law enforcement respondents also believed that successful
investigation and prosecution of cases were hindered by misunderstandings of the nature of trafficking and victimization
(Farrell et al., 2012). Even when law enforcement understood
and recognized trafficking, prosecutors were reluctant to go
forward with cases either because of their own misperceptions
or because they did not believe a jury would respond favorably
current labor and immigration law enforcement actually
to the victim. Farrell and colleagues referred to this as “down-
creates incentives for trafficking and other forms of migrant
stream orientation,” meaning prosecutors weigh how judges
exploitation in the United States. … Border interdiction
and juries will evaluate evidence and how that will impact
strategies, harsh penalties for undocumented migrant
chances of a conviction. If prosecutors expect that the judge or
workers, and insufficient labor protections for all workers,
jury will not understand the force of psychological coercion and
but particularly undocumented migrants, all interact to
the cognitive and behavioral consequences of trauma or will
facilitate trafficking, notwithstanding the TVPA.
hold prejudicial evaluations of victims based on immigration
status, race, appearance, and other factors, they are reluctant
PERCEPTIONS AND MISPERCEPTIONS
OF HUMAN TRAFFICKING
Although scant systematic research exists on societal perceptions of and knowledge about human trafficking (see Menaker
& Miller, 2012, for an exception), there are suggestions in
the literature that such perceptions have significant impact
Unless communities believe trafficking
is a problem, law enforcement
administrators have little incentive to
allot resources to investigations.
to take cases.
Farrell et al. (2012) noted that the very factors that make
individual women and girls vulnerable to trafficking may work
against them. Factors including past abuse, disabilities,
language barriers, undocumented status, being a runaway, or
having parents involved in substance abuse or criminal activity
may result in a victim’s being perceived as not credible or as
not a true victim of a crime. Additionally, these factors may
make it more difficult for the victim to stay engaged in the legal
process. In response to a question about a case that was not
prosecuted, one officer stated:
I suspect that a lot of it had to do with the girls being not
very good witnesses. … Last I heard, one of the girls ended
up getting pregnant and the other girl was a runaway, and
again, almost all of these girls are damaged goods. They
on societal, community, and institutional policy and practice
come from, you know, really abusive backgrounds. They’ve
(Chuang, 1998; Desyllas, 2007; Farrell et al., 2012; Fitzpatrick,
been abused physically or sexually. (Farrell et al., 2012,
2003; Srikantiah, 2007; Williams, 2011). It will be important to
p. 170)
determine to what extent perceptions impact identification of
trafficking situations and victims, willingness of communities
to invest resources to address the problem, jury decisions and
judicial sentencing of perpetrators of this crime, and success of
survivors’ efforts to reintegrate into communities.
Farrell et al. (2012) reported, for example, that unless communities
believe trafficking is a problem, law enforcement administrators
26
Mistrust of the police, social services, and other adult authorities,
combined with a level of savvy about society’s attitudes toward
them and a desire not to relinquish control of their lives, can
create significant barriers between young survivors of CSEC and
those trying to “help” them (Kreston, 2000; Williams, 2011).
Srikantiah (2007) argued that preconceptions about the degree
of control necessary for a situation to count as trafficking have
interfered with implementation of the TVPA, so that not all
of human trafficking, including local vigilance regarding unlawful
business practices (e.g., child labor, minimum wage violations)
must be considered as well.
actual victims are viewed as deserving of services. Similarly,
Chuang (1998) argued that representations and depictions of
trafficking embedded in anti-trafficking policy and law can
mask true diversity of experience. Depictions in awareness
campaigns and training materials can be similarly misleading.
Risk Factors for the
Williams (2011) stated:
Trafficking of Women
and Girls
Institutional Risk Factors
Institutional risk factors for human trafficking include characteristics of the settings in which trafficked women and girls work
and of agencies that respond to trafficking or serve survivors.
The victim image (of the child we must save) may garner
Factors that reduce oversight of employment practices—either
support of charities and politicians but this victim label
by the parent business or by government officials—can increase
may be a great disservice to teens encountered in the field.
worker vulnerability to human trafficking. These practices include
Instead of a sorrowful “victim,” police and service providers
employing labor brokers or labor-leasing services or otherwise
confront a strong, willful survivor. The appearance and
subcontracting labor recruitment and supervision (Brennan, 2008;
demeanor of these “survivors” may result in being viewed
Chacon, 2006; End Human Trafficking Now, 2010; Heyzer, 2002;
as “offenders” because they do not conform to the stereo-
Van Liemt, 2004; see, e.g., United States v. Askarkhodjaev).
type of “victim.” (p. 11)
Employment practices in the informal or “underground” economy
may be especially difficult to monitor (Van Liemt, 2004).6 Workers
can include women and girls employed in private homes as ser-
Community Risk Factors
Many societal risk factors related to trafficking are community
risk factors as well, but the degree of impact varies depending
on community circumstances (Lloyd, 2005; Shelley, 2010). For
example, within the United States, 2011 poverty rates for the total
population (adults and children) ranged by municipality from 4%
to 49.9% (U.S. Department of Agriculture, Economic Research
Service, 2011). Rates for children in poverty in 2011 varied from
12% to 57% (Annie E. Casey Foundation, 2013). Unemployment
rates as of December 2012 ranged from roughly 3% to over 26%
(Bureau of Labor Statistics, 2013). Similarly, variation in communities within source countries differentially impacts the risk for
trafficking out of those communities to the United States.
vants, nannies, housekeepers, and home health care providers.
Law enforcement, health care, and social services agencies’ ability
to identify and respond effectively to trafficked persons depends
on adequate training about human trafficking and an institutional
commitment of resources to address the issue. Lack of training
or of institutional commitment increases the risk that trafficked
women and girls will not be correctly identified or appropriately
served (Reid, 2010). Webber and Shirk (2005) reported that
because human trafficking was first criminalized at the federal
level, federal law enforcement received training first, and local
and state officers are not necessarily trained uniformly or universally. For both law enforcement and service providers, working with
human trafficking cases often requires more staff time than is
required for other cases or clients (Clawson, Dutch, & Cummings,
Community and neighborhood norms impact risk as well. A study
2006; Clawson et al., 2009; Farrell et al., 2010, 2012; Greene,
of CSEC in the United States, Canada, and Mexico found that
Ennett, & Ringwalt, 1999; Todres, 2010). Investigations are com-
youths’ exposure to adult prostitution zones and to social
plex and relatively new for most law enforcement agencies (Farrell
groups that condone or tolerate child–adult sexual relationships
et al., 2012). Service provision may involve multiple agencies,
contributes to their early involvement in commercial sex (Estes
with additional complications if children or non-U.S. citizens are
& Weiner, 2001).
involved (Busch-Armendariz, Nsonwu, & Heffron, 2011; Clawson,
Additional community factors that potentially impact trafficking
risk deserve further scrutiny. These include demographic factors,
Small, Go, & Myles, 2003), and development and maintenance of
interagency collaboration are inherently time consuming.
such as proportions of homeless persons, immigrants and refu-
Farrell and colleagues (2012) addressed factors in the criminal
gees, and adolescents and young adults. Community awareness
justice system that could facilitate identification of and response
27
Sex Trafficking
“Crystal”
Crystal was a 14-year-old American Indian girl in a large midwestern city [in the United States].
She had been placed in a foster home while her mother completed inpatient chemical dependency
treatment. Crystal attended an alternative school and had been a relatively good student, but her
Interpersonal
and
Relationship
Risk Factors
schoolwork had suffered since she began a relationship with man in his early 20s. The boyfriend
Due to the relative scarcity
always picked her up and dropped her off at the school, and staff noted he was often verbally
of research on interpersonal
Report of the Task
abusive. When asked about the relationship, Crystal insisted he loved her and refused to talk
and individual risk factors for
Force on Trafficking
further. After the foster home notified the school that the girl was “on the run,” the school coun-
labor trafficking, most of what
selor called the advocate from an American Indian NGO who did “healthy sexuality” education and
is reported in this section and
outreach at the school. After meeting with the school counselor and the advocate, Crystal agreed
the next is drawn from work on
to begin attending the NGO’s biweekly education and support groups for young Native girls, where
sex-trafficking victimization.
she received cultural teachings about healthy male–female relationships and the respect held
However, this is not meant to
for women and learned traditional sewing and crafts. The advocate also assisted her with finding
suggest that factors at these
housing and meeting basic needs. Six months later, after being beaten by her boyfriend, Crystal
levels do not contribute to risk
revealed to her case worker that he was selling her for sex and asked for help. She was able to
for labor exploitation.
of Women and Girls
safely escape, and police launched an investigation of the pimp/boyfriend. A year later, Crystal
continues to stay connected with the program staff and other girls and is making good progress
toward high school completion.
For minors, the lack of a stable
or protective family structure
is associated with vulnerability
(A. Pierce, personal communication, November 2012. Used with permission.)
to trafficking. Girls displaced
from their homes and families
to human trafficking. The willingness of prosecutors (whether
are at elevated risk for victimization by human traffickers (Lloyd,
state or federal) to take human trafficking cases is essential if
2005, 2011; Norton-Hawk, 2002; Pierce, 2009; Priebe & Suhr, 2005;
officers are to justify devoting time and resources to investigat-
Raphael & Ashley, 2008). The death of a parent, overt abandon-
ing cases. Farrell et al. (2012) found “law enforcement funnels
ment, or emotional abandonment and neglect can cause disruption
resources toward investigating the types of cases prosecutors
in the family structure. Emotional abandonment and neglect
are more likely to accept for prosecution. … This serves to further
and maltreatment by caregivers have been shown to be powerful
perpetuate myths and misunderstanding over the extent to which
precursors of CSEC (Rabinovitch, 2003; Reid, 2010).
human trafficking is a problem in many communities” (p. 156).
Prosecutors’ willingness to take cases was, in turn, influenced
by the newness of legislation and lack of case precedents, level
of support from supervisors, as well as their own knowledge of
human trafficking.
Abandonment and neglect due to substance abuse is a common
theme in the families of adolescent victims of CSEC (NortonHawk, 2002; Raphael & Shapiro, 2002). In a sample of 222 adult
female victims of CSE, 83% reported growing up in homes in which
one or both parents experienced substance abuse and addictions
Reid (2010) reported that within one circuit court in a major met-
(Raphael & Shapiro, 2002). Young girls removed from their families
ropolitan area of the southern United States, minors in CSEC are
of origin and placed in foster or group homes often experience
encouraged to enter guilty pleas in an effort to keep cases moving
intense feelings of emotional isolation and abandonment (Coy,
through the system. However, girls charged with misdemeanor
2008; Rabinovitch, 2003) as well as “confusion, fear, appre-
prostitution are only eligible to be represented by a public defender
hension of the unknown, loss, sadness, anxiety, and stress”
if they plead not guilty. Without legal counsel, the girls are unaware
(Bruskas, 2008, p. 70). To alleviate these feelings, they may run
that the guilty plea they are encouraged to enter can negatively
away from foster care, group homes, or treatment facilities, and
impact their eligibility for services for victims of sex trafficking.
their resulting homelessness makes them particularly vulnerable
This institutional procedure further marginalizes victims by giving
to CSEC (Norton-Hawk, 2002; Raphael & Shapiro, 2002; Silbert &
them a criminal record and blocking access to needed services.
Pines, 1982a).
28
Risk Factors for the
Trafficking of Women
and Girls
Running away or being forced to leave home is a primary factor
Family disruption increases women’s and girls’ psychological
in young adolescents’ vulnerability to sex trafficking (Lloyd,
vulnerability to being trafficked and may reduce their chances of
2005; Reid, 2010; Williams & Frederick, 2009). Traffickers often
exiting or escaping. The need to belong—to be connected to fam-
target female runaways for sexual exploitation (Albanese, 2007).
ily or community—is posited as a fundamental human need that
Unfortunately, young girls who are early and repeat runaways
motivates behavior (Deci & Ryan, 2000; Maslow, 1954; Stevens &
have often been victimized by sexual predators prior to run-
Fiske, 1995). Rachel Lloyd, a trafficking survivor and the founder
ning away and then are victimized again when they run away
and executive director of a nonprofit organization that serves
(Whitbeck, 2000).
survivors of exploitation and sex trafficking, describes how the
Adolescents often run away from home because of parental
neglect, physical or sexual abuse, family substance abuse, and/
or family violence (Janus, Archambault, Brown, & Welsh, 1995;
Janus, McCormack, Burgess, & Hartman, 1987; Molnar, Shade,
Kral, Booth, & Watters, 1998; Smoller, 2001; Whitbeck & Hoyt,
1999; Whitbeck, Hoyt, & Ackley, 1997; Whitbeck & Simons,
1993; Widom & Ames, 1994; Williamson & Prior, 2009). Without
resources or income, homeless and runaway youths are more
likely than other youths to engage in sex in exchange for money
or necessities, increasing their vulnerability to traffickers who
offer the immediate subsistence they need (Clawson et al., 2009;
Greene et al., 1999). Such “survival sex” may not always be
self-initiated; it is often a requirement of the person provid-
disrupted family unit increases psychological vulnerability to
being trafficked (Lloyd, 2011). For domestically trafficked girls,
the longing for a family can be so strong and intense that it
does not take much to create an illusion of family. Traffickers
(i.e., pimps) exploit this, using this craving for family to their
advantage. Some create a pseudo-family structure of girls who
are the “wives-in-law,” headed up by a man who is called
“Daddy”
(Lloyd, 2011). Others use seduction and feigned romantic
attachments to lure girls in need of attention and affection.
The offered affection may be alternated with cruelty and violence,
setting up dynamics that can contribute to traumatic bonding
or Stockholm syndrome (Cantor & Price, 2007; Dutton & Painter,
1993; Graham, 1994; L. A. Smith et al., 2009). 7
ing those resources (Andolina Scott, 2008; Brannigan & Van
Domestic sex trafficking often involves “grooming” (Kennedy,
Brunschot, 1997; Estes & Weiner, 2001; Tyler & Johnson, 2006).
Klein, Bristowe, Cooper, & Yuille, 2007; Polaris Project, n.d.; Reid,
Adolescents sexually abused by a parent or trusted adult are at
heightened risk for unhealthy interpersonal relationships and
revictimization (Gobin & Freyd, 2009). Betrayal trauma theory
provides a framework to understand how being sexually abused as
a child increases the chance of later victimization (Freyd, 2003).
Betrayal trauma theory suggests that when children are abused
by someone they trust, depend on, and care for, the betrayal is
particularly traumatic. Counterintuitively, traumatic betrayals are
remembered less than traumas that did not involve betrayal (Freyd,
DePrince, & Zurbriggen, 2001). This lack of remembering—the
relative inaccessibility of memories of the betrayal—is in some
ways adaptive and protective, as children feel they need the abuser
for their emotional and physical survival (Freyd, 1994, 2003; Freyd,
DePrince, & Greaves, 2007). Betrayal trauma alters a person’s
2010; L. A. Smith et al., 2009; U.S. Department of State, 2008;
Williams, 2010), a recruitment process in which the trafficker/
pimp identifies the psychological and physical needs (i.e.,
vulnerabilities) of targeted victims and then pretends to fulfill
them. The trafficker may develop the initial relationship under the
pretext of being the caring, loving boyfriend, bestowing false love
and attention on his target. This can entail gifts, compliments,
housing, and clothing, as well as sexual, physical, and false emotional intimacy. The trafficker systematically begins to desensitize
the victim to sexual activity. Once the trafficker gains the targeted victim’s trust and affection, the formal exploitation begins,
with the trafficker asking the victim to have sex with “friends”
or complete strangers. If the victim refuses, the trafficker uses
violence, abuse, or coercion to obtain compliance.
ability to accurately trust, resulting in overly trusting behavior or
Reid (2010) described the grooming process as “a mixture of
failure to recognize further betrayal behavior. According to Gobin
reward … and punishment, freedom and bondage, acceptance and
and Freyd (2009), “because of their inability to label someone as
degradation, all used to produce loyalty and trauma bonding to the
untrustworthy and a damaged ‘cheater detector,’ sexual abuse
trafficker” (p. 158). Traffickers are skillful at gaining and maintain-
victims are often more susceptible to exploitation later in romantic
ing dominance and control through manipulation, isolation, violence
partnership” (p. 243).
(physical, sexual, or emotional), economic dependence, coercion,
and threats (Reid, 2010; Smith et al., 2009).
29
Sex Trafficking
trafficker while the girls were
“ Tiffany”
emotionally vulnerable and
then lured from malls, bus
Having run away from her group home, Tiffany, a 12-year-old African American girl, went to New York
stops, arcades, and similar
City. At the NYC terminal, a neatly dressed, polite young man approached her and asked if she was
locations and trafficked into
all right; Tiffany, grateful for the attention, smiled. The young man asked if she would like to get
CSEC. Boxill and Richardson
something to eat. Tiffany accepted and over the meal she began to tell him about running away, her
concluded that the majority
troubled family life (father in jail, mother’s drug addiction, multiple foster/group homes), and her
of girls exhibited the “risk”
Report of the Task
dilemma of not having anywhere to go. He invited her to live with him and to be his girlfriend, prom-
characteristics commonly
Force on Trafficking
ising he would take care of her and they could be like “family.” Tiffany readily accepted, thinking
seen in adjudicated girls
she had found what she always been hoping for, “a home.” The first few weeks were wonderful; her
after being sexually exploited,
“boyfriend” took her shopping and bought her clothes, even a pair of high heels and a sexy dress.
not before. Their conclusion
Tiffany felt like a grown-up wife, cooking and cleaning and having sex nightly. Her boyfriend asked
must be viewed cautiously as
her to dance for him with just her underwear and high heels. Initially she felt awkward, but in time
it is a single study and the
with his encouragement and praise she felt proud to do it for him. After a few weeks, her boyfriend
methodology is not reported;
told her that they were going out to a club. He instructed her to dress sexy and gave her two drinks
however, it would be important
before they left. Tiffany woke the next morning with a hazy memory of the night before, barely recall-
to explore this situation in
ing dancing and stripping. While miserable and feeling like she never wanted to do anything like
further research.
of Women and Girls
this again, her boyfriend was excitedly counting money and verbally praising Tiffany for her actions.
Unable to let him down, Tiffany began her life of sexual exploitation.
Research also identifies prior
involvement in the child pro-
(From Girls Like Us, by R. Lloyd, 2011, New York, NY: HarperCollins. Copyright 2011 by Rachel Lloyd. Adapted with permission.)
tection system and placement
in institutional settings as
In-depth interviews with former pimps and madams in Chicago
background characteristics of youths in CSEC (Farley, Matthews,
(Raphael & Myers-Powell, 2010) revealed they targeted women
et al., 2011; Gorkoff & Runner, 2003; Hay, 2008; Pierce, 2009).
and girls they perceived to be vulnerable, needy, or low in
Victim advocates and survivors of CSEC describe group homes,
self-esteem. One stated, “I looked for girls who needed [things],
foster homes, and shelters as target sites for recruitment by
who would do whatever to come out of the messed up homes and
traffickers, who take advantage of the concentrations of vulner-
escape from their [messed] up parents, and I pulled those girls”
able youth in these settings (Smith et al., 2009).
(p. 5). Another responded, “What would you look for? Broken
bones, unhappy with parents, abused by some sucker.” One pimp
recruited: “I helped girls who no one else would. I always picked
Individual Risk Factors
up throwaways and runaways and dressed them up and taught
In this section we review what is known about correlates of traf-
them how to survive” (p. 5).
ficking risk at the individual level. As mentioned previously, most
claimed he was helping rather than harming the individuals he
Although studies consistently find running away as a risk factor
for CSEC, Boxill and Richardson (2007) cautioned that the reverse
also needs to be considered: Running away and other behavioral
risks may also be effects of sexual victimization rather than
contributors to it. Boxill and Richardson (2007) examined county
juvenile court records for a sample of girls recently involved in
CSEC, reviewing the period of time prior to their CSEC for highrisk behaviors, and reported that most of the girls were “typical
girls,” exhibiting no previous academic, family, or peer-group
maladaptive behaviors. Instead, most had been targeted by a
30
of what is reported here is drawn from work on sex-trafficking
victimization because empirical reports of individual risk factors
for labor trafficking are scarce.
GENDER AND AGE
Globally, women and children make up the largest subset of
victims trafficked into the sex trade (Curtol, Decarli, Di Nicola, &
Savona, 2004; U.S. Department of State, 2004). The International
Labour Organization (2012, p. 1) stated that “women, low-skilled
migrant workers, children, indigenous peoples and other groups
trafficking was confirmed
Sex Trafficking
“Sandy”
involved minors (Kyckelhahn et
al., 2009).
[Sandy] is a 35-year-old transgender woman from Mexico who arrived in the United States in her
twenties. In her hometown, she had been ridiculed for her gender identity, and she was beaten and
severely bullied most of her life. Like many of her peers, Sandy dreamed of a life where she would be
safe and accepted, and she looked for that life in New York City. Once she was in New York, Sandy
suffered an abusive arrest for prostitution and sought help [at the Urban Justice Center]. As she
Risk Factors for the
talked about her immigration experience, it became clear she was a survivor of human trafficking.
Trafficking of Women
In Mexico, she had been unsure about how she could move to the United States with little money and
and Girls
no family support. Ultimately, she was approached by an older man, seduced, and brought to New
York City, supposedly to be his girlfriend. But once they were in New York, he quickly used violence
and threats to force her into prostitution, and he took the money she earned. She escaped after a
year of this sustained abuse.
A second study examined
characteristics of 527 victims
in 389 U.S. trafficking cases
opened between January 2008
and June 2010 (D. Banks &
Kyckelhahn, 2011). All cases
in this sample had been confirmed as human trafficking,
and the U.S. Department of
Justice characterized them
as “high data quality” due
(From “Human Trafficking of Immigrant Transgender Women: Hidden in the Shadows [Web log post], by C. DeBoise, January 11, 2012. Copyright 2014
Race-Talk. Reprinted with permission.)
to consistent and complete
data entry. The vast majority
suffering discrimination on different grounds are disproportionally
of victims in this sample had been trafficked for commercial
affected” by forced labor and slaverylike practices. The extent
sex (90%), and the majority of both sex- and labor-trafficking
of this disproportion is not precisely known, as estimates are
victims were female (94% of sex-trafficking victims; 68% of
plagued by the measurement challenges discussed previously.
labor-trafficking victims). 8 Of those trafficked for commercial
Various studies of U.S. girls trafficked into commercial sex found
the average age of entry to be 13–16 years old (Boyer, 2008; Pierce,
2009; Priebe & Suhr, 2005; Raphael & Ashley, 2008), although
Priebe and Suhr reported girls as young as 10. The Minnesota Indian
Women’s Resource Center found that of 37 clients reporting CSE at
intake, 20% were exploited at age 12 or younger (Pierce, 2009).
Silbert and Pines (1981, p. 408) did not report an average age of
entry, but at the time of their interviews of a sample of 100 women
and girls, “the youngest was 10; … about 60% were 16 and under;
many were 10, 11, 12 and 13 years old.” Lloyd (2005) reported that
the average age of girls referred to Girls Educational and Mentoring
Services for CSEC was 17–19 in 1999 but had decreased to 14–16
years of age.
sex, 49% were age 17 or younger, 85% were under 25, and
95% were under 35. Victims trafficked for labor were somewhat
older, but nevertheless 71% were under 35. However, because
these data were from confirmed cases that had been investigated by federal task forces during a specified time period,
they may not be representative of all trafficking victims.
MARGINALIZATION
A number of demographic characteristics are associated with risk
for sex trafficking. Transgender youth may be more likely than other
children to be CSEC victims (Estes & Weiner, 2001; Stransky &
Finkelhor, 2008; Ugarte et al., 2003; Williamson, Dutch, & Clawson,
2009). Adults who are transgender or gender nonconforming may
also be at heightened risk for sex trafficking (DeBoise, 2012;
Finkelhor and Ormrod (2004) examined data on 200 female minors
Grant et al., 2011). Although investigators did not ask questions
categorized as “juvenile offenders” in prostitution incidents in
about trafficking specifically, results of the National Transgender
the National Incident Based Reporting System from 1997 to 2000.
Discrimination Survey found 11% of transgender and gender
Four percent of the girls were under age 12 (n = 8), 6.5% were
nonconforming respondents “reported having done sex work for
12 or 13, 33% were 14 or 15, and 56.5% were 16 or 17 years of
income,” compared to an estimated 1% of women in the United
age. However, reports of initiation of commercial sexual activity
States (Grant et al., 2011, p. 3). Notably, respondents were most
at age 4 (Farley, Matthews, et al., 2011) and age 5 (Norton-Hawk,
likely to report engaging in sex for income if they had experienced
2002) are also found in the literature. Research based on national
harassment and assault at school, faced bias and harassment
U.S. human trafficking investigations between January 2007
at work, had lost a job or experienced homelessness due to bias,
and September 2008 found that 30.4% of 112 cases in which
had less than a high school education, or were Black or Latino/a.
31
The differential rates suggest discrimination and marginalization
Studies in Chicago, New York, Las Vegas, and throughout Minnesota
as risk factors for CSE.
found that a number of prostituted children are first sold into the
Advocates at the Sex Worker Project of the Urban Justice Center
have reported similar risk factors for transgender Latinas being
trafficked into CSE (DeBoise, 2012). DeBoise reported that
although “a startling number of them met the legal definition for
trafficking” and had been arrested for prostitution on numerous
Report of the Task
Force on Trafficking
of Women and Girls
occasions, “law enforcement had never asked any of these women
if they were being coerced into sex work. Even the minors, who
sex trade by family members (Gragg et al., 2007; Kennedy et al.,
2007; Kennedy & Pucci, 2007; O’Leary & Howard, 2001; Pierce,
2009; Priebe & Suhr, 2005; Raphael & Ashley, 2008).9 Parents and
other family members may indoctrinate their youths into exploitation directly; on the other hand, this way of life may seem normal to
the youths who grew up in the home of a trafficker or a trafficked
mother (e.g., Kingsley & Mark, 2000; Pierce, 2009).
automatically meet the federal definition for human trafficking,
Additionally, the ongoing impact of historical trauma (Brave
had not been screened or identified as trafficked” (p. 1).
Heart, 2003; Brave Heart & DeBruyn, 1998) or generational
Research in Chicago, Atlanta, Toledo, Seattle, and New York City
found disproportionate representation of African American girls
among youths exploited in commercial sex (Boxill & Richardson,
2005; Boyer, 2008; Curtis, Terry, Dank, Dombrowski, & Khan, 2008;
Gragg, Petta, Bernstein, Eisen, & Quinn, 2007; O’Leary & Howard,
2001; Williamson & Prior, 2009). Additionally, several U.S. studies
(Farley et al., 2003; Farley, Matthews, et al., 2011) and government
reports (U.S. Department of State, 2011b) noted that Native populations are especially vulnerable to trafficking. While one study
found that prostituted girls in upstate New York juvenile systems
were most often White (Andolina Scott, 2008), FBI agents in Alaska
and Minnesota reported traffickers’ targeting of American Indian/
Alaska Native girls because they were “versatile” and could be
marketed in the sex trade as “exotic” Hawaiian, Asian, or Native
girls (Pierce & Koepplinger, 2011).
PRIOR VICTIMIZATION AND TRAUMA EXPERIENCE
A number of studies found that childhood sexual assault is a common past experience among women and children in CSE (Bagley
& Young, 1987; Boxill & Richardson, 2005; Kramer & Berg, 2003;
Lloyd, 2005; McClanahan et al., 1999; Reid, 2010; Senn & Carey,
2010; Silbert & Pines, 1981, 1982a, 1982b; Simons & Whitbeck,
1991; Tyler, Whitbeck, Hoyt, & Yoder, 2000; Van Dorn et al., 2005).
Reid (2010, p. 149) argued that a child’s “normative self-protection reactions” may be disrupted by both psychological and
neurobiological consequences of abuse (see also Reid & Jones,
2011). Other research suggests childhood sexual abuse, a child’s
trauma (Pierce, 2009), defined as the psychological legacy of government-sanctioned colonization, genocide, displacement, forced
removal of children to residential schools and adoptive families,
and political and legal disenfranchisement, has been implicated in the vulnerability of American Indian, Alaska Native, and
Canadian Aboriginal women and children to sex traffickers (Farley,
Matthews, et al., 2011; Kingsley & Mark, 2000; Pierce, 2009).10
The psychological impact of historical slavery, colonialism, and
oppression of other ethnic and racial groups as a potential contributor to vulnerability to trafficking warrants further scrutiny.11
DEVELOPMENTAL, EMOTIONAL, AND COGNITIVE FACTORS
Developmental research shows that adolescents may be malleable
and susceptible to outside influences and environmental settings
(Reid, 2011; Reid & Jones, 2011; Steinberg & Cauffman, 1996).
Adolescents also tend to make impulsive decisions and seek
out intense, risky experiences, especially with peers (Gardner &
Steinberg, 2005; Steinberg & Scott, 2003). Two particular emotional
states may contribute to adolescent girls’ vulnerability to sex
traffickers: (a) self-isolation as a response to not feeling safe and
(b) being emotionally distressed (Boxill & Richardson, 2007). Even
fleeting stress stemming from a single heated argument with a parent or friend can be a vulnerable moment (Ryan & Lindgren, 1999).
On the other hand, such emotional states may be the long-term outcomes of abuse or neglect (Schoenberg, Riggins, & Salmond, 2003).
Regardless of the etiology, adolescents in either of these emotional
states are particularly vulnerable to traffickers’ ruses.
self-image, and her attitude toward sexual activity contribute to
In an innovative study, Reid (2011) explored the role of sexual
vulnerability to CSEC (Schissel & Fedec, 1999).
denigration of self or others as a potential contributor to risk for
A particularly heinous category of childhood sexual victimization
involves having been sold for CSEC by family members, including
mothers, fathers, siblings, aunts and uncles, and foster parents.
32
CSE, in addition to previously studied risk factors (e.g., childhood maltreatment, substance use, running away). Examples of
sexual denigration included beliefs such as “no man would care
for [me] without a sexual relationship” and “only bad, worthless
Labor Trafficking
of State, Human Smuggling
“Jocelyn”
& Trafficking Center, 2006;
Watts & Zimmerman, 2002).
Jocelyn, an adult woman from Southeast Asia with four children, was seeking work in the United
Displacement from home
States to better support her family. She came to the United States on an H-2B visa, having been
and community results in the
promised a 40-hour work week at minimum wage in hotel housekeeping. She and her workmates
weakening or loss of protective
instead were forced to work more than 100 hours each week in a hotel and café in a western town
social support, thereby increas-
of fewer than 500 people. Their documents and earnings were confiscated, and threats of violence
ing an individual’s vulnerability
Risk Factors for the
and legal action were used to control them. Jocelyn’s traffickers were the married couple who
to trafficking (Heyzer, 2002).
Trafficking of Women
owned the franchise to the chain motel in which Jocelyn was enslaved.
and Girls
(From the Human Trafficking Law Project database, 2013, Ann Arbor, MI: University of Michigan Law School. Copyright 2014 by the Regents of the
University of Michigan. Adapted with permission.)
In research based on surveys
of service providers and
trafficking-related newspa-
guys would be interested in [me]” (Reid, 2011, p. 149). Reid found
per articles in the United States, researchers at the University of
that childhood maltreatment predicted running away, substance
California, Berkeley, found that foreign-born persons represented
use, and sexual denigration but that sexual denigration was the
80% of victims in 131 identified cases (Free the Slaves & Human
strongest predictor of childhood sexual exploitation.
Rights Center, 2004). Analysis of data from 389 confirmed human
Research also identified fetal alcohol exposure as a factor that
increases a child’s vulnerability to commercial sex exploitation (Boland & Durwyn, 1999; Hunt, 2006; Olson, Burgess, &
Streissguth, 1992; Streissguth, 2005). Because of high rates of
fetal alcohol syndrome in American Indian, Alaska Native, and
Canadian Aboriginal communities, children in these populations
may be at increased risk for CSEC (Hunt, 2006; Kingsley & Mark,
2000; Pierce, 2009; Vancouver/Richmond Health Board, 1999).
trafficking cases from 2008 to 2010 (D. Banks & Kyckelhahn,
2011) showed that one third of all victims were foreign born, and
53 of the 63 confirmed victims of labor trafficking were foreign
born (one was a U.S. citizen or national; the citizenship of nine
victims was unknown). Of labor-trafficking victims, 67% were
undocumented, but 28% had legal authorization to work in the
United States (D. Banks & Kyckelhahn, 2011). In one recent case,
the U.S. Department of Justice indicted Global Horizons, Inc., a
labor recruiting company, for trafficking more than 400 migrant
Although the vulnerability to trafficking of individuals with
Thai workers for forced labor in 13 states. The company deported
physical or cognitive disabilities or developmental delays has
recruits who did not cooperate with its demands (Polaris Project,
not been formally studied, they may be at elevated risk for
2012; U.S. Department of Justice, 2010b).
sexual abuse and exploitation (Tang & Lee, 1999; Tharinger et
al., 1990), suggesting they are at elevated risk for trafficking.
with disabilities or developmental delays for both labor and sex
Conclusion
trafficking (McGraw, 2009; U.S. Attorney’s Office, 2009, 2012,
A host of factors at multiple levels contribute to risk for human
2013; U.S. v. Adriana Paoletti-Lemus, 1998).
trafficking. Conditions that permit or condone exploitive labor
Several cases of trafficking involve victimization of persons
and sexual exploitation, tolerate or fail to regulate unscrupuIMMIGRANT OR REFUGEE STATUS
lous business practices, and maintain status inequalities and
Immigrants, refugees, asylees, and internally displaced persons
marginalization all contribute to the phenomenon. Factors that
(people displaced within their own nation by economic status, polit-
undermine an individual’s capabilities for self-protection or that
ical upheaval, natural disasters, or armed conflict) are susceptible
disrupt her connection to social and familial protection increase
to human trafficking because of social isolation, language barriers,
her vulnerability. Therapeutic response to survivors of trafficking
and lack of a reliable source of protection (Free the Slaves & Human
requires sensitivity to the unique constellation of factors that
Rights Center, 2004; Gajic-Veljanoski & Stewart, 2007; Hodge,
contributed to that survivor’s victimization. Primary prevention
2008; Human Rights Watch, 2001, 2012; Kara, 2010; Sturdevant &
of future victimization requires addressing the persistent social,
Stoltzfus, 1992; U.S. Department of State, 2011b; U.S. Department
economic, and political factors that place populations at risk.
33
DESCRIBING HUMAN TRAFFICKING
Traffickers, Facilitators,
and Perpetrators
“Human
trafficker” is a label encompassing many functions, from
same nationality or ethnicity as their victims and “often … are
recently naturalized United States citizens with close ties to their
country of origin” (p. 14). However, “[w]hen the perpetrator was a
U.S. citizen not of recent origin, the cases tended to concentrate
recruitment, to transportation, to training, to exploitation of
in certain areas of exploitation, especially the sexual exploitation
trafficking victims. A wide variety of persons can and do carry
of children and the trafficking of very young children for adoption”
out these functions. How these functions are managed varies,
(2004, p. 14).
ranging from a single individual performing them all to an organized network of associates.
Whether perpetrators are acting alone or as part of a larger
enterprise, the crime requires some organizational skill. For
Initially, human trafficking was assumed to be largely con-
transnational trafficking, travel documents must be obtained
trolled by organized crime (see, e.g., Caldwell, Galster, Kanics,
or forged, public authorities or law enforcement may need to
& Steinzor, 1999; Farr 2005; Morawska, 2007; O’Neill Richard,
be bribed, and illegal border crossings must be managed.
2000; S. Shannon 1999; Shelley, 2007, 2010; Sulaimanova, 2006).
For both domestic and transnational trafficking, roles include
Additional research and practice have revealed that this conclu-
harboring and controlling victims, exploiting them in the
sion was overly simplistic (Bruckert & Parent, 2002; UNODC,
specific setting, and laundering any monies obtained from
2010). For example, a study of federally prosecuted CSEC cases
illegal enterprises. These actions, however, do not necessarily
found that 90% of those sampled had a single defendant (Small,
require traditional networks of organized crime. As Bruckert
Adams, Owen, & Roland, 2008).
and Parent (2002) concluded from their literature review, “the
The most effective recruiters seem to be those who have or can
establish trust relationships with potential victims. The Human
association between trafficking and organized crime is neither
self-evident nor always very substantial” (p. 19).
Rights Center (2005) pointed out that perpetrators frequently are
The individuals carrying out human trafficking functions are
familiar to their victims—they may be relatives, neighbors, or
highly diverse (UNODC, 2011). They may be victims’ family mem-
people from the same town. Free the Slaves and the Human Rights
bers, acquaintances, or intimate partners. They may be known
Center (2004) further reported that perpetrators are often of the
and trusted members of the victim’s community or strangers.
nations included in the report
Sex Trafficking
“Danielle”
(UNODC, 2009). Some of
these women were former
Danielle was a White teenager born in a college town in the northwestern United States. She expe-
trafficking victims (Shelley,
rienced extensive emotional and sexual abuse as a child. Before she was 15, she left home and
2010; Sidun & Rubin, 2013;
was living on the streets in a nearby city, couch surfing, and living in squats. As a minor, she had
UNODC, 2009). According
exchanged sex for money, food, and drugs. When she was 16, her drug supplier began prostituting her,
to Sidun and Rubin, “It is
using physical force and drugs to maintain control of her. She had been arrested several times for
extremely troubling that
Describing Human
prostitution, both as a teen and as an adult, but no one had ever investigated further to determine why
some former victims become
Trafficking
she was on the streets.
traffickers, and research to
(From the Human Trafficking Law Project Database, 2013, Ann Arbor, MI: University of Michigan Law School. Copyright 2014 by the Regents of the
understand the psychologi-
University of Michigan. Adapted with permission.)
cal, financial, and coercive
reasons why women would
They include a wide variety of authority figures—school teach-
recruit other women into slavery demands attention (p. 165).”
ers, government officials, military personnel, religious leaders.
Additionally, they include persons involved in a variety of other
criminal activities such as gang activity and drug dealing
(National Gang Intelligence Center, 2011). Mitchell et al. (2010)
Means of Trafficking
found that many pimps exploiting youths were known to law
Force, fraud, and coercion are the means of trafficking explicitly
enforcement authorities and had connections to local gangs or
identified within the TVPA, but each of these may take a variety of
other organized criminal groups, businesses, or websites through
forms.1 Traffickers may use indebtedness, fraudulent job advertise-
which they offered the prostituted girls.
ments, changes in promised employment after arrival in the United
According to a 2009 report from the UNODC, it is not uncommon for
traffickers to be women. In the 46 countries for which sufficient data
were available to analyze convictions by gender, convicted traffickers
were women in over 50% of cases in 14 countries, between 10% and
50% in 28 countries, and less than 10% in four countries (UNODC,
2009). This finding is confirmed by other researchers (Coonan, 2004;
Kyckelhahn et al., 2009; Shelley, 2010) and through adjudicated
cases (e.g., U.S. v. Akouavi Kpade Afolabi, 2009; U.S. v. Adriana
Paoletti-Lemus, 1998; U.S. v. Calimlim, 2006). Of the 112 confirmed cases of human trafficking from U.S. federally funded task
forces, women were suspected perpetrators in 23% of sex-trafficking
and 46% of labor-trafficking cases (Kyckelhahn et al., 2009).
States on a guest visa, fraudulent marriage offers and recruitment
via marriage brokers (commonly referred to as “mail order brides”),
legal insecurity, drug addiction, and a variety of psychological
means to manipulate and coerce potential victims (Bauer, 2007;
Hynes, 2002; Pierce, 2009; Pierce & Koepplinger, 2011; Raphael,
2004; Raymond & Hughes, 2001; U.S. Department of State, 2011b).
According to these authors, traffickers may target women and girls
with particular vulnerabilities such as homelessness, addiction,
disabilities, mental illness, or gender nonconformity.
COERCION AND PSYCHOLOGICAL ABUSE
Coercion is the thread that links the overlapping experiences of
trafficked persons with victims of sexual abuse, domestic violence,
Shelley (2010) indicated that women in trafficking operations,
migrant women, women exploited for labor, and survivors of torture
unlike those in many other criminal activities, often hold positions
(Hopper & Hidalgo, 2006). Although physical coercion is readily
of authority. Female traffickers exploit women and girls in domes-
understood and widely studied, psychological coercion, a form of
tic servitude, service industries, and commercial sexual activity
mental violence (Hopper & Hidalgo, 2006; J. Kim, 2010), is insuffi-
(Coonan, 2004; Shelley, 2010). Acting independently or in concert
ciently discussed in the trafficking literature.
with others (sometimes a spouse or partner), women recruit, train,
and control victims, maintain brothels, and reap considerable
profit (Shelley, 2010). Conviction rates of women are higher for
trafficking than for other crimes in a number of nations studied,
and more women than men were convicted of trafficking in 14
35
Coercion that does not result in physical consequences often
poses legal challenges in proving cases of trafficking, rape,
domestic violence, and torture and in considering refugee/asylum
cases (Farrell et al., 2012; Hopper & Hidalgo, 2006; J. Kim, 2010).
Sex Trafficking
Raphael and Ashley (2008)
Coercion
interviewed 100 women
between the ages of 16 and 25
“The
coercion I faced [in strip club prostitution] did not involve physical force. Instead, the coercion
Report of the Task
in commercial sex between
being accepted in the straight world after being a ‘whore,’ induction into the sex world ‘family’
the ages of 12 and 23. The
(one that accepts those not accepted elsewhere and a closed system that is difficult to leave), and
women spoke of coercion
knowledge that I could not make ends meet and that I would never make the same amount of money
in the recruiting process,
(even with a PhD).”
including verbal abuse (40%),
(From Taylor Lee, “In and Out: A Survivor’s Memoir of Stripping,” in Rebecca Whisnant & Christine Stark (Eds.), Not for Sale: Feminists Resisting
reminders of indebtedness
Prostitution and Pornography (pp. 56-63), 2004, Melbourne, Australia: Spinifex Press. Permission to reproduce kindly granted by the publisher.)
for clothing and other items
Force on Trafficking
of Women and Girls
who had first become involved
was emotional and psychological in nature. This included socialization as a sex object, fear of never
(32%), withholding of drugs
Farrell and colleagues (2012) conducted extensive interviews with
(12%), threats to end a romantic relationship (23%), threats of
law enforcement and prosecutors in counties across the United
harm (29%), and threats of being kicked out of the home (20%).
States regarding their efforts to investigate and prosecute human
On the basis of interviews with 13 survivors of CSEC, Williamson
trafficking at the state and local level. They found that a lack
and Prior (2009) described manipulation or “finesse pimping,”
of understanding of the dynamics of psychological coercion was
including making girls feel that they need to repay the kindness
a significant obstacle in convincing judges and juries of the
shown to them by engaging in commercial sex and bringing the
seriousness of human trafficking. When there was no element of
money “home.”
physical force, prosecutors had to overcome misperceptions that
the victim was complicit in her own victimization, acting freely,
or at least able to leave if she really wanted to. This was the
case for victims of labor trafficking and for both minor and adult
victims of sex trafficking. One prosecutor stated, “The perception from jurors is, ‘Well this is slavery, they got a ball, iron ball
attached to their leg, and they’re wearing rags and sleeping in
shipping containers’” (Farrell et al., 2012, p. 185).
Coercive methods of control perpetrated by traffickers are often
tantamount to torture. Trafficked women have been locked in
rooms; forced to witness violence perpetrated on others (Kurtz,
Surratt, Inciardi, & Kiley, 2004; Zimmerman et al., 2003); controlled and deprived of freedom of movement (Di Tommaso, Shima,
Strom, & Bettio, 2009; J. Kim, 2010; K. Kim, 2011); separated
from children (Choi et al., 2009; Zimmerman et al., 2003); and
emotionally abused, shamed, and neglected (Choi et al., 2009).
The 2008 reauthorization of the TVPA provided additional clari-
Other methods of coercion include threatening harm or death to
fication of the term coercion. In his explanatory remarks on the
the victim or to family members (Acharya, 2008; Choi et al., 2009;
reauthorization, Rep. Howard Berman (D-CA) (2008) stated that
Hopper & Hidalgo, 2006; Hossain et al., 2010), or telling victims
the intent was to make clear that means of trafficking included
they had been purchased (Zimmerman et al., 2003). In addition,
psychological, financial, and reputational harm and threats of
control of physical appearance, body weight, clothing, and activ-
harm, as well as physical force or threats of violence. Berman
ities such as eating, sleeping, and toileting are used (Choi et al.,
(2008) elaborated:
2009). In the case of internationally trafficked people, isolation
It is contemplated that these refinements will streamline
the jury’s consideration in cases involving coercion and
will more fully capture the imbalance of power between
trafficker and victim. A scheme, plan, or pattern intended
to inculcate a belief of serious harm may refer to nonviolent and psychological coercion, including but not limited
to isolation, denial of sleep and punishments, or preying on
mental illness, infirmity, drug use or addictions (whether
pre-existing or developed by the trafficker). (p. H10904)
36
from their culture and language is another means of control (Free
the Slaves & Human Rights Center, 2004; Human Rights Watch,
2001; Logan, Walker, & Hunt, 2009).
PHYSICAL AND SEXUAL VIOLENCE
Violence is used as a mechanism of trafficking as well as a
means of controlling and maintaining the exploitative relationship. Evidence from studies with women exploited in commercial
sex in the United States indicates high rates of physical and
Sex Trafficking
placement of chili powder in
“I didn’t know who I was anymore”
their eyes and vaginas; Bauer
and Ramírez (2010) reported
[A] teenager, who had been trafficked by members of her own extended family was subjected to
that victims of labor exploita-
beatings with a shoe, starvation, forced labor for as many as 19 hours a day and a sense of menace
tion in the United States were
so extreme that whenever she and her trafficked younger brother were sent out to Safeway to buy
blindfolded with duct tape and
water, they never attempted escape. Rather, since they knew that their trips outside were being
struck with meat hooks in a
timed by the trafficker, they put all their energy into carrying the heavy water and other bundles as
meat processing plant.
Describing Human
quickly as they could back to their house of confinement. In addition, although she spoke English
Trafficking
and knew how to contact police, the teenager was afraid to call law enforcement because the
trafficker had changed the victim’s name and her age on her passport and “told so many lies that I
didn’t know who I was anymore.”
Physical harms perpetrated
on trafficked women can be
extreme and life threatening.
In a cohort of nearly 2,000 sex-
(From the Family Violence Prevention Fund (FVPF) publication Turning Pain Into Power: Trafficking Survivors’ Perspectives on Early Intervention
Strategies, 2005, p. 17, San Francisco, CA: Author. Copyright 2013 by FVPF. Reprinted with permission.)
ually exploited women followed
for 3 decades, homicide was
sexual violence perpetrated by pimps and clients, including
the leading cause of premature death (Potterat et al., 2004). The
rape, physical assault, gunshots, knife wounds, and threats
standard workplace homicide rate for these women was 7 times
with a weapon (Dalla, 2000; El-Bassel, Witte, Wada, Gilbert, &
higher than for male taxicab drivers and 51 times higher than
Wallace, 2001; Farley & Barkan, 1998; Farley et al., 2003; Farley,
for female liquor store workers, two occupations with the highest
Matthews, et al., 2011; Hynes, 2002; Kennedy et al., 2007;
homicide rates in the United States during the time of the study.
Raphael & Shapiro, 2004).
The authors stated that to their knowledge, “no population of
Studies ranged from one third to 90% of participants reporting
experiences of violence: 32.4% (El-Bassel et al., 2001), 72%
(Dalla, 2000), 82% (Farley & Barkan, 1998), 84% (Farley,
Matthews, et al., 2011), 84% and up (Hynes, 2002), and from
women studied previously has had a crude mortality rate, standardized mortality ratio, or percentage of deaths due to murder
even approximating those observed in our cohort” (Potterat et al.,
2004, p. 783).
56% to 91% in a study of nine nations (Farley et al., 2003). 2 One
Several researchers report that for most victims of CSEC, the
third to two thirds of participants reported having been raped,
initial exploitation is more likely to occur via pretenses of love,
and in one study over half of rape victims reported more than
affection, or access to perceived needs such as shelter, food,
five rapes (Farley et al., 2003). 3 International studies revealed
or drugs rather than immediate violence; physical violence
extreme forms of physical and sexual violence against traf-
escalated later (Kennedy et al., 2007; Raphael & Ashley, 2008;
ficked women and girls in the Middle East, South Asia, Africa,
Reid, 2010; Williams & Frederick, 2009). However, each reported a
Mexico, Canada, and Europe (Acharya, 2008; Acharya & Clark,
minority of respondents for whom the entry into CSEC was brutal.
2010; Aronowitz, 2009; Bokhari, 2008; Cwikel, Chudakov, Paikin,
Agmon, & Belmaker, 2004; Di Tommaso et al., 2009; Farley,
ABUSIVE WORK AND LIVING CONDITIONS
Matthews, et al., 2011; Hossain, Zimmerman, Abas, Light, &
Women trafficked for labor are at high risk for physical injury and
Watts, 2010; Kennedy et al., 2007; Sarkar et al., 2008).
illness (Freedom Network, 2010). Abuse includes deprivation of
Experiences of torture are also common in trafficking cases
(Hynes, 2002; Zimmerman et al., 2003), and there are similarities
in the experiences of torture survivors and trafficking victims
(Farley, Baral, Kiremire, & Sezgin, 1998; Farley & Barkan, 1998).
Two studies illustrated the torturous experience of the trafficked
persons they studied: Acharya (2008) reported that sex-trafficking victims in Mexico City experienced intentional burns and
37
basic needs, as well as nonphysical and psychologically coercive
tactics; such tactics are injurious but difficult to prove (Free the
Slaves & Human Rights Center, 2004; Human Rights Center, 2005;
Human Rights Watch, 2001; J. Kim, 2010; K. Kim, 2011). Migrant
workers as a group are vulnerable to labor trafficking; both U.S.
and international studies on the health conditions of migrant
workers revealed deplorable work conditions (APA, Presidential
Task Force on Immigration, 2012; American University Washington
Sex Trafficking
among the girls in their CSEC
“Brittany”
sample, 58% had been moved
away from their homes and
A man approached Brittany at a mall in her hometown, asked if she was looking for a job, and gave
26% had been moved to other
her a business card for a local restaurant he owned. When Brittany called the number on the card,
states by their traffickers.
the man confirmed that he was looking for waitresses to start working immediately. Brittany needed
Self-initiated movement
the job and asked for the restaurant’s address, but the man told her he would pick her up at the
is also a common pattern;
mall where they first met. Instead of going to the restaurant, the man drove her to a nearby hotel
women and girls may leave
Report of the Task
and told her that she was going to be a prostitute instead of a waitress. At gunpoint, Brittany was
untenable home situations,
Force on Trafficking
force to drink bottles of vodka and take blue pills that made her dizzy and disoriented. Brittany tried
flee their traffickers, or move
to look for help but was locked in the hotel room without access to a phone. After three days of
in search of better options
being beaten, drugged, and forced to have sex with at least 60 men, Brittany managed to escape
for rebuilding their lives.
and asked the first car she saw to call the police. Polaris provided case management services to
Regardless of the reason for
Brittany, and with time and a strong support system she was able to enroll in school.
relocation, frequent move-
(From Brittany: Escort Service Sex Trafficking, Washington, DC: Polaris Project. Copyright 2014 by Polaris. Reprinted with permission. Names, loca-
ment—especially between
of Women and Girls
tions, and other identifying information have been changed and/or omitted to preserve the confidentiality of the populations Polaris Project serves.)
service areas or legal jurisdictions—creates difficulties
College of Law International Human Rights Law Clinic & Centro
for accessing needed services (Williams & Frederick, 2009).
de los Derechos del Migrante, 2010; Bauer, 2007; Chuang, 2010;
Hsu, 2007; Human Rights Watch, 2012; Preibisch & Hennebry,
DRUGS AND ALCOHOL
2011; Verité, 2010). Inadequate food and shelter, denial of
Several international studies from India, Mexico, and Thailand
breaks, including bathroom breaks, and exposure to toxic levels
found that traffickers forced drug use as a form of coercion
of pesticides threaten health (Arcury & Quandt, 2007; Bauer
(Acharya, 2008; Falb et al., 2011; Goldenberg et al., 2012; Gupta,
& Ramírez, 2010; Curl et al., 2002; Hansen & Donohoe, 2003).
Raj, Decker, Reed, & Silverman, 2009). Some reports suggest that
Both sex-trafficking victims (Acharya, 2008; Cwikel, Ilan, &
U.S. traffickers also control their victims with substance use and
Chudakov, 2003; Di Tommaso et al., 2009; Kennedy et al., 2007)
addiction (Logan, Walker, & Hunt, 2009; Raphael & Ashley, 2008).
and domestic workers (Domestic Workers United & Data Center,
Additionally, preexisting drug use can be a risk factor for youth
2006; Human Rights Watch, 2001) are subject to excessive
involvement in exchanging sex for money (Edwards, Iritani, &
workloads, long hours, and unsafe working conditions. For exam-
Hallfors, 2006) and for trafficking.
ple, Human Rights Watch (2001) conducted interviews regarding
employment conditions of 43 domestic workers and found that
“both
the average and the median workday was fourteen hours,
THE INTERNET
Sex businesses exploit the Internet and communication technol-
with most workers working at least six-day weeks and ten work-
ogy to offer commercial sex services around the world (Arizona
ing seven. Only three workers reported working ten hours or less
State University, 2012; Blevins & Holt, 2009; Reid, 2010).
per day” (p. 17).
Internet websites now provide contact information, specifics on
sexual acts, pornography of the woman to be prostituted, coded
MOVEMENT
prices, 4 and reviews by sex buyers (Blevins & Holt, 2009; Castle
Although movement of victims is not required for the crime
& Lee, 2008; Holt & Blevins, 2007). Classified advertisement
of human trafficking, it is nevertheless a technique used by
websites, such as Craigslist and Backpage.com, have been used
traffickers to maintain control (Hynes, 2002; Hynes & Raymond,
to advertise commercial sex services, including sex with minors
2002; Johnson, 2012; Rieger, 2007). Separation from familiar
(Cunningham & Kendall, 2011; Roe-Sepowitz, 2012; see the
locales and frequent movement reduce the chances that victims
Human Trafficking Law Project, 2013, for specific cases using
will be able to escape the situation or connect with potential
the Internet). Durschlag and Goswami (2008) reported 34% of
sources of assistance. Raphael and Ashley (2008) reported that
their sample of men who purchased sex in Chicago (n = 113)
used the Internet to contact women, with Craigslist being the
38
Sex Trafficking
“Shayna”
At 17 years old, Shayna was trafficked by a man and a woman who operated an online escort and
prostitution business. The traffickers made Shayna and the other girls post photos and solicitations for customers on Internet sites like redlightspecial.com or Backpage.com’s adult section.
Customers arranged “dates” via the website, and the traffickers used an online service to reserve
motel rooms for the “dates.” The trafficking ring was investigated, and the operators were
Describing Human
eventually sentenced for trafficking children, coercion and enticement, transportation for illegal
Trafficking
sexual activity, and conspiracy.
(From the Human Trafficking Law Project Database, 2013, Ann Arbor, MI: University of Michigan Law School. Copyright 2014 by the Regents of the
University of Michigan. Adapted with permission.)
most frequently used site. Curtis et al. (2008) interviewed youths
engaged in commercial sex (survival sex as well as pimpcontrolled activity) and found that of 249 youth interviewed, 23%
used the Internet to find customers.
Although research has begun to address the role of the
Internet in sexual predation targeting children and youth (e.g.,
Dombrowski, LeMasney, Ahia, & Dickson, 2004; Wolak, Finkelhor,
Mitchell, & Ybarra, 2008), a limited number of empirical studies
were identified that focused specifically on trafficking and
commercial exploitation via the Internet. In July 2012, Microsoft
awarded six research grants in North America to examine the role
of technology in CSEC. Although the grants are limited to the
study of sexually exploited children, they are a positive step in
addressing the use of modern technology in trafficking in general
(Microsoft News Center, 2012).
As well as facilitating trafficking, the Internet can be used as a
law enforcement tool to identify victims, gather strong evidence
against perpetrators, and address demand for CSEC. One such
effort involved using Craigslist to post advertisements clearly
indicating prostitution of a minor as the basis for a reverse
sting operation, which yielded convictions of seven men intending to purchase sex with a child (U.S. Attorney’s Office, 2009).
39
CONSEQUENCES AND IMPACT
OF TRAFFICKING
There is a pressing need to recognize human trafficking as a
United States was not a destination, source, or transit country.
health issue (Beyrer, 2004; Gushulak & MacPherson, 2000; Hynes,
Although geographical, social, and political contexts may differ,
2002; Zimmerman et al., 2003) and to apply a public health
information about the consequences of trafficking drawn from
approach to address its consequences (Todres, 2011). Zimmerman
this literature can advance understanding of trafficking in the
et al. (2003) and Hynes and Raymond (2002) argued that the
United States. 3 In addition, research on populations that typi-
health risks and consequences trafficking poses for women and
cally contain trafficked persons was taken into account under
girls are comparable to those resulting from forced migration,
the assumption that women and girls trafficked into forced
sexual abuse, intimate partner violence, torture, or exploitive
labor, domestic servitude, or other work would not experience
labor. There are serious psychological and physical health conse-
better health and mental health outcomes than the occupational
quences for women and girls involved in trafficking.
group as a whole, and women and girls trafficked for prostitution are unlikely to experience better outcomes than women and
girls in prostitution where trafficking status is not known.
Literature Review
There is a scarcity of empirically based research on the physical
and psychological consequences of human trafficking for women
Mental Health Consequences
and girls in the United States. As a result, the task force drew
RELATIONSHIP COMPLEXITIES
from existing literature pertaining to trafficking outside of the
Psychological coercion and abuse dramatically disrupt rela-
United States and populations that typically contain trafficked
tionship dynamics for trafficked women and girls. According to
women and girls. 1 Under U.S. federal law, the prostitution of
Herman (1992):
minors is human trafficking (e.g., commercial sex with a person
under the age of 18). As such, research on the consequences
of prostitution with samples of minors was considered, even
if the authors did not explicitly address trafficking. 2 Also
considered was literature pertaining to trafficking in which the
Traumatic events have primary effects not only on the psychological structures of the self but also on the systems of
attachment and meaning that link individuals and community. … Traumatic events destroy the victim’s fundamental
assumptions about the safety of the world, the positive value
researchers found that victimization is related to increased use
of the self, and the meaningful order of creation. (p. 51)
of all defenses to cope with trauma (Mounier & Andujo, 2003).
Many victims are subjected to “traumatic subordinate relationships” in which they engage in behaviors to appease the perpetrator’s potential for violence (Cantor & Price, 2007). As a result,
they may present with ambivalent attachment responses to their
traffickers. Cantor and Price (2007) also noted that complex PTSD
Consequences and
Impact of Trafficking
is common in populations that have been subjected to “traumatic
subordinate relationships” characterized by life-threatening
entrapment. The perpetrator commonly engages in small and sporadic acts of kindness, isolates the victim from perspectives other
than those of the perpetrator, and creates a situation from which
the victim feels she cannot escape.
These factors are also common determinants of Stockholm
syndrome. Although not formally recognized as a mental health
diagnosis (Namnyak et al., 2008), Stockholm syndrome is classically associated with hostage situations.4 Graham and colleagues
(1995) found the disorder was a common form of coping for
female undergraduate students in abusive relationships. Namnyak
and colleagues’ (2008) meta-analytic review of Stockholm syndrome studies found that in most cases, psychological violence––
as opposed to physical violence––and kindness by the perpetrator
increased the victim’s attachment following escape.
Another study with women who had left abusive relationships
(Dutton & Painter, 1993) found that alternating good and bad
treatment appeared to strengthen the feelings of attachment to the
abusive partner over time. Other studies found that victims might
engage in behaviors of appeasement; victims of intimate partner
violence, for instance, may behave in a childlike manner toward the
batterer (Cantor & Price, 2007), thus making it seem as though the
victim is willingly with the perpetrator. Similarly, trafficking victims
might describe loving feelings and engage in compassionate and
kind behaviors toward the trafficker (Stark & Hodgson, 2003). Such
behaviors, however, should not be mistaken for a willingness to
remain in the trafficking situation but rather viewed as a complex
trauma response akin to the ambivalence to leave that is common
among victims of intimate partner violence. Additionally, reintegration into the community may be more difficult because the survivor
could be perceived as complicit in her own captivity. Such perceptions have the potential to retraumatize survivors.
One particular defense mechanism, splitting, involves the victim’s adapting her responses to please the perpetrator, focusing
on that person’s positive behaviors and ignoring his or her negative behaviors. Splitting reduces the capacity of the victim to
distinguish between safe and dangerous people and is damaging
to relationships. The use of splitting was associated with cumulative experiences of child maltreatment, multiple experiences
of victimization, and sexual abuse (Mounier & Andujo, 2003)—
common traumas among women and girls prior to trafficking.
Splitting could contribute to the vulnerability of homeless and
runaway youth to trafficking and retrafficking.
Research demonstrating that social pain and physical pain
activate similar neural pathways (Eisenberger, 2012; Eisenberger
& Lieberman, 2004) can begin to shed light on the physiological
effects psychological coercion has on trafficked women and
girls. 5 In addition to the isolating and controlling impact of
coercion during the trafficking situation, survivors who escape
may face discrimination and social exclusion that lead to further
isolation. For instance, in a study of undergraduates’ perceptions of commercially and sexually exploited minors, Menaker
and Miller (2012) found that the more information participants
had about a girl’s history of victimization and coercion, the less
blame they placed on the girl.
On the basis of the findings of neurobiological research (e.g.,
Eisenberger, 2012; Eisenberger & Lieberman, 2004), A. Banks
(2011) emphasized that recovering the ability to relate and
connect is central to treating trauma-affected women. A. Banks
(2006) noted that in addition to recovering from the health, spiritual, and cognitive impairments resulting from chronic abuse,
the largest obstacle to healing for women is recovering from a
destroyed sense of relationships. This is consistent with Herman’s
(1992, 1997) stages of recovery model, work by Dalla and
colleagues (L. M. Baker et al., 2010; Dalla, 2006) on the exit process, and work by Freyd and colleagues (Freyd, 1994, 2003; Freyd
et al., 2007) on betrayal trauma.
DEPRESSION AND ANXIETY
Studies with both U.S. (Alegría et al., 1994; Dalla et al., 2003;
Edwards et al., 2006; Perdue et al., 2012; Twill, Green, & Traylor,
Cumulative victimization experiences impact people’s beliefs
2010) and non-U.S. samples of CSE and trafficked women found
about themselves and others. For example, in a study that
elevated rates of depression (Choi et al., 2009; Hossain et al.,
assessed defense mechanisms used by homeless youths,
2010; Jung et al., 2008; Roxburgh, Degenhardt, & Copeland, 2006;
41
Tsutsumi, Izutsu, Poudyal, Kato, & Marui, 2008; Zimmerman et
(Farley, Matthews, et al., 2011). Studies with non-U.S. samples
al., 2003, 2006). Nearly all women (95%) endorsed “depression/
of trafficked women also found elevated rates of PTSD (Choi et
feeling very sad” within the first couple of weeks of exiting a traf-
al., 2009; Hossain et al., 2010; Jung et al., 2008; Roxburgh et al.,
ficking situation (Zimmerman et al., 2006, p.18). These women
2006; Tsutsumi et al., 2008; Zimmerman et al., 2003, 2006).
also reported loneliness (88%), and over three fourths (78%)
experienced feelings of worthlessness (Zimmerman et al., 2006).
In addition, anxiety and hostility were psychological sympReport of the Task
Force on Trafficking
of Women and Girls
toms detected among trafficked women (Alexander, Kellogg, &
Thompson, 2005; Williamson, Dutch, & Clawson, 2010; Zimmerman
et al., 2003, 2006). Zimmerman et al. (2006) found that “among
the anxiety-related symptoms reported, ‘nervousness,’ ‘fearful,’
and feeling ‘tense or keyed up’ were the most prevalent (between
COMPLEX PTSD
Although elevated levels of PTSD are found in samples of trafficked women and girls, additional symptomology suggests that
the PTSD diagnosis cannot comprehensively capture the psychological harms of trafficking. Instead, a complex trauma approach
can provide a comprehensive understanding of the multiple
symptoms and the psychological consequences of trafficking.
84% and 91% at the first interview)” (p. 18). At interviews 3
PTSD may present following a single or discrete traumatic
months later, these survivors were still endorsing feelings of
event. In contrast, complex PTSD results from multiple or
nervousness (51%) and fearfulness (43%) (Zimmerman et al.,
persistent trauma. Many trafficked persons have suffered multiple
2006). Immediately upon exiting trafficking, 83% of the survivors
forms of trauma, including events that predate the experi-
reported feelings easily irritated or annoyed, and temper outbursts
ence of trafficking, such as physical abuse (Dalla et al., 2003;
continued to be an issue with 67% of the survivors 3 months later
Goldenberg et al., 2012; Perdue et al., 2012; Zimmerman et al.,
(Zimmerman et al., 2006).
2008) and sexual abuse (Burnette et al., 2008; Farley et al., 1998;
James & Meyerding, 1977; Kramer & Berg, 2003; Loza et al., 2010;
POSTTRAUMATIC STRESS DISORDER (PTSD)
McClanahan et al., 1999; Senn & Carey, 2010; Silbert & Pines,
Posttraumatic stress disorder (PTSD) was identified as a psychiat-
1981, 1982a, 1982b; Simons & Whitbeck, 1991; Tyler, Whitbeck,
ric diagnosis in the third edition of the Diagnostic and Statistical
Hoyt, & Cauce, 2004; Widom, 1995). Traffickers may gain their
Manual of Mental Disorders (DSM–III; American Psychiatric
victims’ trust or even be family and community members well
Association, 1980) and has been modified through subsequent DSM
known to the victim. The combination of abuse and close relation-
revisions, including the most recent edition, the DSM-5 (American
ship with the trafficker makes this population highly vulnerable to
Psychiatric Association, 2013, 5th ed.). PTSD can result from
complex trauma, or trauma that is purposefully inflicted through
trauma exposure and may include a combination of debilitating
the actions of another person through sexual abuse, relation-
symptoms, including avoidance of trauma-triggering stimuli,
ship violence, exploitation, or similar violations (Courtois, 2008;
reexperiencing symptoms (e.g., flashbacks), hypervigilance (e.g.,
Herman, 1992, 1997).
startle response), and hyperarousal states (e.g., sleep disorders).
The DSM-5 includes “negative alterations in cognitions and mood”
as diagnostic criteria (p. 271). This can include loss of memory,
self-blame for the trauma, mistrust of others, and other “persistent
and exaggerated negative beliefs or expectations about oneself,
others, or the world” (p. 271). Such distorted beliefs can be particularly challenging in the therapy setting; they may interfere with
the survivor’s ability to reestablish trusting relationships and may
increase risk for self-injurious behavior.
Persons exposed to such extreme, chronic, and relational forms of
trauma may exhibit symptoms that go beyond typical PTSD. The
set of symptoms has been identified as complex PTSD (Herman,
1992), also known as “disorders of extreme stress not otherwise specified” (Luxenberg, Spinazzola, & van der Kolk, 2001).
Complex trauma contributes to a combination of alterations in
the individual’s affect regulation, consciousness, self-perception,
perception of the perpetrator, relationships with others, and in
systems of meaning (Herman, 1997; Luxenberg et al., 2001). In
In a study with trafficked and prostituted women from nine
an attempt to regulate affect, victims who present with complex
nations, Farley and colleagues (2003) found that 68% of the
PTSD may turn to substance abuse, cutting, disordered eating,
women in the full sample and 69% of the women in the U.S.
suicidal gestures, or other forms of self-injurious behaviors.
sample met criteria for PTSD. Over 50% of a group of trafficked
Comorbid diagnoses, such as PTSD, depression, and anxiety are
Native American women in the United States met criteria for PTSD
42
understood as part of the overall complex PTSD presentation
memory, information, and affect. In a dissociated state, the normal
(Courtois, 2004).
integration process fails. Research over the last 2 decades demon-
Determinants influencing the degree of psychopathology in
complex PTSD include the type of trauma, with relational traumas
increasing vulnerability; multiple or chronic experiences of
trauma; the victim’s relationship to the perpetrator; the community’s reaction to the traumatic event (e.g., supportive, judgmental);
Consequences and
Impact of Trafficking
and the particular defense (e.g., fight, flight, or freeze/submit)
activated during the traumatic event (McEwen, 2002; Scaer,
strates a relationship between traumatic stress and pathological
forms of dissociation (Putnam, 1995). Pathological dissociation
experiences result in serious impairment of memory and identity.
These disruptions may lead to a range of dissociative disorders
(Putnam, 1993). Dissociation can also impact cognitive functioning necessary for learning and decision making (Kimble, Fleming,
Bandy, & Zambetti, 2010).
2001). Age is a factor, with younger victims at greater risk for
Defense mechanisms associated with dissociative disorders
complex PTSD (Cole & Putnam, 1992; Herman, 1992, 1997; Scaer,
were prevalent in homeless runaway youths who had experi-
2001; van der Kolk, 1988).
enced multiple forms of victimization and abuse (Mounier &
One Korean study demonstrated that when compared with
non-trafficked women (n = 31), trafficked women (n = 46) had
higher rates of both PTSD and complex PTSD resulting from a
combination of the coercive experiences during trafficking and
from histories of physical and sexual abuse and other traumas
prior to trafficking (Choi et al., 2009). Complex PTSD symptoms included somatization, dissociative experiences, identity
problems, relational problems, and affect regulation problems.
Studies with trafficked women found that
dissociation’s etiology may be twofold:
linked to high rates of childhood physical
and sexual abuse followed by violent
victimization during trafficking.
Andujo, 2003). In a study of sexually abused girls, dissociation
was related to sexual abuse by multiple perpetrators coupled
with physical abuse (Putnam, Helmers, Horowitz, & Trickett,
1995). According to Choi et al. (2009), studies with trafficked
women found that dissociation’s etiology may be twofold: linked
to high rates of childhood physical and sexual abuse followed
by violent victimization during trafficking.
Dissociation is common among those in escort, street, massage,
strip club, and brothel prostitution and frequently is accompanied by PTSD, depression, eating disorders, and substance
abuse (Farley, Matthews, et al., 2011; Ross, Anderson, Heber, &
Norton, 1990; Ross, Farley, & Schwartz, 2003; Vanwesenbeeck,
1994). In a sample of non-U.S. women (n = 207) who had
survived trafficking, more than 33% reported difficulty recalling
complete or even minor details of the most horrific events to
which they were subjected, and memory deficits were a problem
for 63% (Zimmerman et al., 2006). Anecdotally, many trafficked
women report using dissociativelike defenses to tolerate their
traumatic experiences, but limited research exists to clarify
Related to this, a study of trafficked girls in India with a history
how the process unfolds or how it impacts functioning after the
of sexual abuse (n = 120) showed that the girls had high levels of
experience of trafficking. 6
aggression (Deb, Mukherjee, & Mathews, 2011), a form of affect
dysregulation that can be related to the complex PTSD diagnosis.
SELF-INJURIOUS AND SUICIDAL BEHAVIORS
Schissel and Fedec (1999) found higher rates of self-injurious
DISSOCIATION
behaviors in the form of cutting among trafficked Canadian
Pathological dissociation can result from early childhood trauma
Aboriginal and non-Aboriginal youths than among those from
and may be compounded by exposure to multiple traumas through-
both groups who had not been trafficked. Trafficking was also
out the lifespan (Putnam, 1995). Thus, trafficked individuals may
associated with increased suicidal tendencies and more suicide
present with this symptom. Dissociation is a psychophysiological
attempts. In samples of marginalized and homeless youths in
process that triggers a unique form of consciousness, which is
British Columbia (Saewyc, MacKay, Anderson, & Drozda, 2008),
present in all individuals to a greater or lesser degree (Putnam,
the risks for self-harm and for considering, planning, or attempt-
1993). In normal states of consciousness, the individual integrates
ing suicide were two to three times higher among sexually
43
Report of the Task
exploited youths than among nonexploited youths. Thirty-eight
Long work hours and dangerous working conditions combined
percent of a sample of European women reported having suicidal
with limited rest, limited nutrition, and lack of access to medical
thoughts within the first weeks after exiting their trafficking
care (Choi et al., 2009; Di Tommaso et al., 2009; Holmes, 2007)
situations, and many stated that during the time they were
contribute to fatigue, incapacitating physical pain, disfiguring
trafficked, they seriously considered suicide (Zimmerman et al.,
and disabling injuries, and increased risk of infectious diseases
2006). Burnette et al. (2008) found that women participating in a
such as tuberculosis (Bauer, 2007; Bauer & Ramírez, 2010;
substance abuse program who had been exploited in commercial
Dharmadhikari, Gupta, Decker, Raj, & Silverman, 2009; Huffman,
sex experienced a higher rate of lifetime suicide attempts than
Veen, Hennink, & McFarland, 2012).
did substance-abusing women without a history of exploitation.
Force on Trafficking
Substance abuse and addictions also negatively affect health
status (Burnette et al., 2008; Jung et al., 2008; Schissel &
of Women and Girls
Physical Health Consequences
Trafficked and sexually exploited women report a variety of
health concerns, including neurological issues (Chudakov, Ilan,
Belmaker, & Cwikel, 2002; Farley et al., 1998, 2003; Farley &
Barkan, 1998; Farley, Lynne, & Cotton, 2005; Zimmerman et
al., 2006, 2008); gastrointestinal disturbances (Farley et al.,
2003; Zimmerman et al., 2006, 2008); respiratory distress
Fedec, 1999). Burnette et al. (2008) interviewed more than 1,500
women receiving substance abuse services. Over half (n = 816)
reported having exchanged sex for money or drugs at some time
in their lives; these women were significantly younger, had a
lower educational level, and were more likely to be homeless than
women who had not engaged in commercial sex. They also were
significantly more likely to have a history of inpatient treatment
and of crack cocaine, polysubstance, and intravenous drug use.
(Farley et al., 2003, 2005; Zimmerman et al., 2008); cardio-
In a study of African American women (n = 203) who reported
vascular disorders (Chudakov et al., 2002; Farley et al., 2003,
smoking crack cocaine, women who engaged in commercial sex
2005; Zimmerman et al., 2006, 2008); chronic pain, urogenital
reported a higher severity of drug use and were more likely to use
problems, and injuries, including fractures, broken and missing
drugs to decrease guilt and increase their sense of control, con-
teeth, and traumatic brain injury (Chudakov et al., 2002; Farley
fidence, and closeness to others, compared with women who had
et al., 2003, 2005; Potterat et al., 2004; Raymond et al., 2002;
not engaged in commercial sex (Young, Boyd, & Hubbell, 2000).
Zimmerman et al., 2003, 2006, 2008).
The study suggests that although attempts to fund their drug use
Trafficked women also reported a range of reproductive and sexual
health issues, such as pain during menstruation and intercourse,
heavy bleeding, abnormal vaginal discharge, and unwanted pregnancies and abortions (Acharya, 2008; Choi et al., 2009; Cwikel et
may have contributed to commercial sex activities, the women’s
drug use likely increased as a way to deal with negative aspects
of the work, a finding also noted in qualitative studies (Dalla,
2002; Murphy, 2010).
al., 2003; Decker, McCauley, Phuengsamran, Janyam, & Silverman,
2011; Farley et al., 2003, 2005; Zimmerman et al., 2003, 2006).
Studies of women exploited in commercial sex in the United
Additional Consequences
States found rates of HIV infection ranging from 14% to 28%
In addition to experiencing the physical and psychological con-
(Alegría et al., 1994; Burnette et al., 2008; El-Bassel et al.,
sequences of trafficking, trafficked women and girls often face
2001). In a U.S. sample of clients seeking substance abuse treat-
financial, community, and family stressors directly related to
ment, Burnette and colleagues (2008) found rates of HIV/AIDS
their trafficking experience (DeRiviere, 2006). Feelings of shame
four times higher, rates of hepatitis four times higher, and rates
about the experience of trafficking may impede them from seek-
of other sexually transmitted infections (STIs) almost six times
ing support from their families and communities (Hart, 2012;
higher among women who had engaged in commercial sex (n =
Miller, Decker, Silverman, & Raj, 2007; Poudel & Carryer, 2000;
816) than among women who had not (n = 790).
Shigekane, 2007; Vijeyarasa & Stein, 2010).
44
Sex Trafficking
PTSD
“Escaping
a captor isn’t even a halfway point to recovery. For 3 years I was tortured, raped, endured
sensory deprivation, placed in restraints, … malnourished, and had absolutely no control over any part
of my life. Life for me as a captive was always cause and effect—usually with violent consequences.
Even involving things I had no control over; for example, bruising from a vicious beating was cause for
punishment. … This has profoundly impacted my life even though I escaped nearly 30 years ago.
Consequences and
Impact of Trafficking
Since my captivity ended, I’ve had eight surgeries … caused by what I suffered in captivity. For
many years I considered myself very fortunate. Most of my injuries appeared to just be scars until
the years of abuse caught up with me in the form of delayed-onset injuries. Many injuries can’t be
repaired. My raspy voice is the direct result of trauma and has no resolution. While I have managed to
live a semi-normal life physically, I have … lost years of income … unable to work as a result of the
injuries.
From an emotional perspective … an escaped captive will have PTSD. … It will likely take years of
counseling to learn to deal with the most common symptoms of PTSD including nightmares, flashbacks, hyper vigilance [sic] and/or an emotional flat affect. There will also be a process of learning
to trust again and developing healthy relationships. … Part of recovering from captivity is regaining
one’s sense of self worth and coping with being treated as damaged goods by people … once they
become aware of the victim’s history. A long term captive’s emotional and psychological responses are
also altered in ways that are less obvious. When freedom has been taken away and replaced with living
in abstract fear of death, with violence that is often incomprehensible and in response to uncontrollable events, that devastates one’s psychology and how they view and react to the world after escape.
Freedom is something that I literally have had to relearn, and am still learning. Something as basic
and normal as asking a friend to stop at a restaurant because I’m hungry or need to use the restroom
are examples of what I have had to relearn. I still take instruction far too literally, fearing an aggressive or violent response. … This is PTSD. This takes many years of intense therapy to overcome and it
is a lifelong process.”
(Reprinted from “One Former Slave on Helping Cleveland Kidnap Victims,” by J. Brenneman, May 27, 2013 [Web blog post]. Reprinted with permission.)
Although lack of education can increase a person’s vulnerability to
crime victims may have juvenile or criminal records; such records
trafficking, trafficking itself can contribute to lack of education.
can interfere with opportunities for employment, housing, and
Minors trafficked for labor or commercial sex may be prevented
access to services (Reid, 2010).
from attending school or may drop out of school (Massachusetts
Department of Education, 1989; Massachusetts Department of
Elementary and Secondary Education, 2009; Pierce, personal
communication, March 30, 2013; U.S. v. Abdel Nasser Youssef
Ibrahim, 2006; U.S. v. Abdenasser Ennassime, 2006). Others may
continue to attend school but not receive the full benefit of their
education due to physical exhaustion and psychological trauma
(Flores & Wells, 2010). Limited educational attainment may then
increase subsequent vulnerability because of restricted employment options. Victims who were treated as offenders rather than
45
RESPONDING TO TRAFFICKING
OF WOMEN AND GIRLS
Prevention, protection, prosecution, and partnership—the “4
Ps”—serve as the “fundamental international framework used
by the United States and internationally to combat contemporary forms of slavery” (U.S. Department of State, 2011a).1 These
categories facilitate communication across professional and geographical domains and help identify work that needs to be done.
The task force recognizes, however, that the distinctions among
Prevention
Prevention must be the centerpiece of any effort to combat human
trafficking. Prevention is preferable to providing remediation
services for victims of the abuse, deprivation, and violence of this
crime because it is more protective of health and is a matter of
justice and basic human rights.
them are somewhat artificial. In practice, professionals may
Compared to efforts to identify and serve victims and survivors, to
actually concurrently be contributing to protection, prevention,
investigate and prosecute traffickers, or to build partnerships,
and prosecution. Psychologists entering the field of anti-traffick-
prevention has received less attention from researchers, funding
ing work should be prepared to partner with professionals from
sources, media, and governmental and nongovernmental entities
a variety of disciplines. They must also recognize that this work
involved in anti-trafficking work (Barrett & Shaw, 2011; Chuang,
will—and should—be complex.
2006; Dettmeijer, 2009; Shinkle, 2007; Todres, 2010). Overall, the
Although there is much to be learned about which interventions are
most effective, a variety of programs have been implemented to
address prevention, protection, and prosecution. This section will
provide a brief overview of programs and policy responses currently
in use in the United States.
approach to prevention of human trafficking in the United States
has not been comprehensive or systematic. Many approaches seem
promising, but their impact in terms of preventing victimization is
largely unknown, and there is limited reporting on these programs in the peer-reviewed literature. Programs described in the
following sections illustrate different approaches to prevention,
but inclusion is not meant to imply these programs were evaluated
and found to be effective. All types of prevention programs need to
be evaluated for developmental appropriateness and for competence in reaching diverse cultural and language groups. Campaign
effectiveness should be improved by including survivors of labor
and sex trafficking in planning and development.
vary depending on the
Sex Trafficking
“Teodora”
Responding to
organization’s philosophy and
target population. Services
Teodora entered the United States on a J-1 visa, recruited by what she believed to be a legitimate
typically include information
modeling business. Instead, she and other women from Eastern Europe were forced to work 70–80
about sexual health, commer-
hours a week as strippers and exotic dancers in a midwestern city. Her passport was confiscated by
cial sex myths, targeting and
the traffickers, her wages were withheld to repay the exorbitant debt the recruiters claimed she owed
recruitment tactics, as well
them, and she was controlled by threats of violence and deportation. The traffickers included men
as safety planning, identify-
and women, foreign nationals, and naturalized U.S. citizens.
ing resources, and building
(From the Human Trafficking Law Project Database, 2013, Ann Arbor, MI: University of Michigan Law School. Copyright 2014 by the Regents of the
self-esteem. Several programs
Trafficking of Women
and Girls
employ survivors of CSE to
University of Michigan. Adapted with permission.)
facilitate empowerment groups
AWARENESS AND EDUCATIONAL CAMPAIGNS
or to act as role models, encouraging education, leadership, and
The goals of awareness and educational campaigns are both
advocacy (Hotaling, Burris, Johnson, Bird, & Melbye, 2003; Lloyd,
primary and secondary prevention. Primary prevention is accom-
2008; Justice Resource Institute, 2012; Pierce, 2012).2
plished by alerting potential trafficking victims about fraudulent
employment offers, visa schemes, or pimp recruitment. Secondary
prevention is aided by early victim identification and connection
to services to reduce chances of revictimization. Some campaigns are large international and national programs funded
by intergovernmental organizations (e.g., Blue Heart Campaign
Against Human Trafficking; UNODC, 2012), nongovernmental
organizations (NGOs; e.g., Free the Slaves, Truckers Against
Trafficking), or the federal government (e.g., U.S. Department
of Homeland Security’s [2012] Blue Campaign), while some
campaigns are small-scale efforts conducted by local NGOs,
faith-based organizations, or service agencies.
The U.S. State Department (2009) developed a “Know Your Rights”
pamphlet as part of a promising campaign to inform foreign
nationals coming to the United States on nonimmigrant visas
about their workplace rights. According to early information from
the National Human Trafficking Resource Center (NHTRC, 2010,
2011), the pamphlet brought about “increased call volume [to
the national hotline] from a number of different foreign-born visa
holders experiencing diverse types of exploitation.”
EMPOWERMENT PROGRAMS
In addition to their educational components, programs at the
Minnesota Indian Women’s Resource Center (MIWRC; Pierce, 2012)
include holistic health care (e.g., acupuncture, acupressure, and
massage as a source of safe, healing touch) and cultural teachings. A 6-month outcome assessment for one MIWRC program
with a sample of adolescent girls (n = 17) showed that, relative
to baseline, fewer girls reported homelessness and relationship
abuse, and more girls reported improved family relationships
and increased school attendance. There was, however, no change
in the number of girls exposed to threats of violence. Girls did
not report any change in amount of police contact, although the
nature of their contact changed from involvement in unlawful
behavior to reporting victimization (Pierce, 2012).
A comprehensive, strengths-based program for runaway girls
who had been sexually exploited or sexually abused showed
favorable results in restoring supportive relationships, reducing
traumatic distress, reducing risk behaviors, and increasing selfcare (Saewyc & Edinburgh, 2010). Some of the services provided
in this program included home visits to strengthen relationships, mental health screenings, goal setting, health education,
and empowerment groups.
Empowerment programs for women and girls at risk of trafficking
Recognizing and building on the existing strengths of survivors,
in commercial sex (primary prevention) or exiting commercial
as well as developing new ones, is a common theme in the CSE
sex (secondary prevention) commonly address key factors that
literature (Harvey & Tummala-Narra, 2007; Lloyd, 2008, 2011;
increase risk of trafficking or act as barriers to exiting, such as
Saewyc & Edinburgh, 2010; Williams, 2010, 2011; Williams &
homelessness, substance use, history of violent victimization, and
Frederick, 2009). Trafficked women and girls have had to endure
lack of means of support. Most often established by NGOs that
extreme circumstances; the coping skills, strength, and determi-
provide direct services for survivors, empowerment approaches
nation that kept them alive should not be overlooked. Along with
47
having significant needs, survivors will also have significant
variety of forms at both the individual and the community level.
resources that they can develop. Williams (2011) argued compel-
On an individual level, some approaches include seizure of vehicles
lingly for not underestimating survivors:
used in soliciting prostitution, shaming through letters sent to
We found that, when asked, many homeless, runaway and
thrown away youth were able to articulate significant aspirations and dreams. For example, while many of the youth
had experienced considerable difficulties with school, it was
clear that for many teens these difficulties did not dampen
Report of the Task
their enthusiasm about or aspirations to complete their high
Force on Trafficking
school educations or attain higher degrees. Many homeless
of Women and Girls
youth spontaneously mentioned school as one of the top
the homes of arrested sex buyers or by publicizing the solicitors’
identities on websites or billboards, reverse stings in which a
law enforcement officer poses as a prostitute and the sex buyer
is arrested,5 and “john schools” or educational programs (with
attendance required as a condition of sentencing for solicitation)
designed to discourage purchasing commercial sex (Abt Associates,
n.d.; Shively, Kliorys, Wheeler, & Hunt, 2012; Willoughby & Lee,
2008; Yen, 2008).
three things that were important to them. This is significant
Although demand for a “product” is essential to support the
considering the multiple challenges of survival the runaway
enterprise of human trafficking, surprisingly little attention
and homeless youth faced on a day to day basis. (p. 4)
has been paid to purchasers of commercial sex, even those who
Existing programs that show promise appear to be comprehensive
(i.e., they include educational, relational, therapeutic, and other
contribute to the sexual exploitation of children. Schauer and
Wheaton (2006) stated that
components), strengths-based, culturally competent, and survi-
the masculine actors, the purchasers of sexual services … vor-informed. Initial successes are encouraging, but evaluation of
and pimps, receive either no or “slap-on-the-wrist”-type sanc-
long-term effectiveness of existing programs regarding prevention
tions. Twenty-five states have no statutes that sanction the
of victimization or revictimization is not yet available and will
behavior of those buying sexual services, whereas 9 have none
be important to an understanding of factors that best promote the
sanctioning the pimp; however, 47 states make prostitution
well-being of women and girls.
(i.e., women selling sexual favors) a crime. (p. 150)
3
EDUCATION, JOB TRAINING, AND CAREER COUNSELING
Beyond curricula to raise awareness of trafficking, primary prevention of human trafficking demands high-quality educational
opportunities from early childhood to ensure all children have the
foundation for meaningful career options and self-sufficiency.
Adolescents need educational and career counseling as well as real
job opportunities to enhance their resistance to trafficking schemes
and reduce the chances they will exploit others. Educational
Yen (2008) argued that “the sexual desires and preferences of the
male customers who purchase commercial sexual acts … influence
and direct all aspects of sex trafficking, from the type of girls that
are recruited to the location of the brothels” (p. 665). Research
examining the motivations, beliefs, and behaviors of purchasers
of commercial sex may contribute to efforts to reduce demand
and prevent trafficking (see Durschlag & Goswami, 2008; Farley,
MacLeod, et al., 2011; Schapiro Group, 2010).
programs, career counseling, and job training are also essential
Community-based approaches include media campaigns to
secondary prevention strategies for girls and women who have
change social norms, such as the “Dear John” campaign in
been trafficked and are seeking to rebuild their lives. The U.S.
Atlanta, GA (Kotrla, 2010; National Criminal Justice Reference
Department of Health and Human Services and the U.S. Department
Service, 2009; Willoughby & Lee, 2008), which uses billboards
of Labor make education and job training programs available to
and public service announcements in the form of letters to sex
survivors of human trafficking (Siskin & Sun Wyler, 2010). Public
buyers stating that sexual exploitation of Atlanta’s youth is not
schools and universities can provide additional programs to
tolerated. Programs such as the Chicago Alliance Against Sexual
enhance opportunities for survivors.
Exploitation (CAASE) curriculum for young men of high-school
4
age focus on reducing demand for commercial sex by exploring
DEMAND REDUCTION
The philosophy behind demand reduction efforts is that the demand
for commercial sex or for cheap labor, services, and consumer goods
drives trafficking. Demand reduction for commercial sex takes a
48
and challenging social norms (CAASE, n.d.; Dunn Burque, 2009).
The “Swedish model” is a promising approach to reducing
demand that needs further investigation. 6 On the basis of the
assumption that prostitution and sex trafficking constitute
awareness of the human costs and violations of human rights
violence against women, this approach decriminalizes the sale
embedded in the production process and in supply chains.
of sex while instituting strong penalties for the purchase of com-
For example, the Coalition of Immokalee Workers (CIW) led a
mercial sex (Committee of Inquiry to Evaluate the Ban Against
successful campaign to increase prices paid by major retailers
the Purchase of Sexual Services, 2010; Ekberg, 2004). In other
for tomatoes grown in Florida. This effort was one aspect of CIW’s
words, Swedish law criminalizes the clients of commercial sex
anti-slavery campaign, complementing its work to investigate and
but not the sexually exploited persons. The Swedish approach has
expose labor trafficking in Florida agriculture. A series of con-
been hailed by many observers as being successful in substan-
trolled field studies suggests that campaigns to raise awareness
Responding to
tially reducing prostitution at the street level in Sweden and in
of trafficking and exploitation may positively influence con-
Trafficking of Women
reducing trafficking of persons into Sweden for the purpose of
sumer behavior (Hainmueller, Hiscox, & Sequeira, 2011; Hiscox,
prostitution (Claude, 2010; Ekberg, 2004; Shively et al., 2012;
Broukhim, Litwin, & Woloski, 2011; Hiscox & Smyth, 2011).
and Girls
Willoughby & Lee, 2008). Eriksson and Gavanas (2008) acknowledged immediate reductions of street-level prostitution following
POLICY APPROACHES
the passage of the law; however, they concluded that prostitution
Prevention can be addressed through policy efforts at the local,
has been increasing over subsequent years and in 2007 was
state, national, and international level; such efforts have the
about two thirds as prevalent as it had been prior to the law.
potential to impact trafficking comprehensively and consistently.
Swedish law criminalizes the clients
of commercial sex but not the sexually
exploited persons.
However, current U.S. policy focuses on prosecution of traffickers
and services for survivors, which may reduce revictimization but
do not address primary prevention needs.
One policy approach is to expose trafficking in supply chains
through efforts such as the enacted California Transparency in
Supply Chains Act of 2010 and the proposed federal Business
Erikson and Gavanas also suggested that there were widely
differing views among their respondents about the success of the
law in reducing demand. Shively et al. (2012) reviewed a wide
range of demand-reduction approaches toward sex trafficking
and concluded:
Transparency on Trafficking and Slavery Act (2011). In addition,
the TVPRA of 2005 mandates that the U.S. Department of Labor
“carry
out … activities to monitor and combat forced labor and
child labor in foreign countries.” Such activities include creating
a publicly available list of goods “that the Bureau of International
Labor Affairs has reason to believe are produced by forced labor or
Evidence that anti-demand tactics (or comprehensive
child labor in violation of international standards”; by developing
approaches that include addressing demand) can effectively
a standard set of practices that will reduce the likelihood that
suppress commercial sex markets is slowly accumulating and
listed goods will continue to be produced with such labor; and by
is robust in relation to evidence of the effectiveness of other
consulting with other U.S. government agencies “to reduce forced
approaches. However, formal evaluations are still confined to
and child labor internationally and ensure that products made by
evaluations of a few anti-demand approaches implemented
forced labor and child labor in violation of international standards
in a few locations. (p. v)
are not imported into the United States” (TVPRA, 2005).
Although addressed in the literature less often, the relationship
Finally, a number of authors point to components of the U.S.
between human trafficking and the demand for nonsexual services
temporary-visa system that allow serious abuses including
and products (labor trafficking) must be considered and addressed
human trafficking (Bales & Soodalter, 2009; Bauer, 2007; Bauer
as well. Major retailers—and ultimately, individual consumers—
& Ramírez, 2010; Coalition of Immokalee Workers, 2012). Of
benefit from lower priced services or consumer goods that may be
most concern are visas that directly tie domestic servants and
produced using forced or coerced labor, including forced child labor
“guest
workers” in agriculture, fisheries, and other industries
(Bales & Soodalter, 2009; Bauer, 2007; Bauer & Ramírez, 2010;
to their employers, with little oversight or protection from the
Coalition of Immokalee Workers, 2012). Prevention campaigns
federal government. Some efforts have been made to address
often focus on changing individual consumer behavior by raising
these problems, but business groups blocked an attempt to
7
49
reduce abuses in the H-2 visa program in federal court (Bayou
and the T-visa program (Busch-Armendariz, 2012; Busch-
Lawn & Landscape Services et al. v. Hilda Solis et al., 2012).
Armendariz et al., 2011).8 However, these avenues have not always
Until substantial changes are made in a number of the visa pro-
been used. According to Farrell et al. (2012), “Findings from our
grams, especially those that give employers unfettered discretion
research suggest that this is more complicated in practice and
over the legal status, safety, and well-being of foreign workers,
does not always happen” (p. 167); one respondent reported
persons coming to the United States to work will be at elevated
instances of potential trafficking victims being “deported admin-
risk for human trafficking.
istratively” because “we don’t have the resources to deal with
every illegal alien case” (Farrell et al., 2012, p. 167).
Report of the Task
Force on Trafficking
of Women and Girls
Protection
According to the Colorado Project to Comprehensively Combat
Human Trafficking website (Laboratory to Combat Human
Trafficking, n.d.):
Given that protection is specifically enumerated in the federal
TVPA and in state anti-trafficking laws, psychologists need
a general understanding of how human trafficking laws can
potentially impact their ability to provide services to clients, to
refer clients to certain types of programs, and to pursue (or not)
legal remedies. Much of the responsibility for meeting needs
Protection measures ensure that human trafficking victims
and protecting survivors of trafficking is shouldered by a host of
are provided access to health care, counseling, legal and
NGOs. Some NGOs focus on specific populations (e.g., domestic
shelter services in ways that are not prejudicial against vic-
minors), whereas others address human trafficking more globally.
tims’ rights, dignity, or psychological well-being. Protection
In addition, many agencies (e.g., domestic violence agencies,
also means creating an environment (social, political and
child advocacy centers, homeless shelters, refugee resettlement
legal) that fosters the protection of victims of trafficking.
agencies, pregnancy centers) serving other populations may
Numerous studies identify a similar range of needs (Aron, Zweig,
serve human trafficking survivors as well.
& Newmark, 2006; Clawson et al., 2009; Jones & Yousefzadeh,
Challenges to meeting survivors’ needs include (a) lack of sufficient
2006; Macy & Johns, 2011) and highlight the importance of meet-
training to identify human trafficking when encountered, (b) inad-
ing changing needs over time.
equate resources (e.g., trained staff, funding) to meet client needs
The post-trafficking needs of trafficking survivors vary depending
on their specific circumstances (e.g., whether they are adults or
minors; whether it is safe for them to return home; whether they
speak English; whether they are U.S. citizens, lawful permanent
residents, lawful temporary migrants, or undocumented immigrants). Each individual’s circumstances—prior to, during, and
following the trafficking—are different, and the survivor should be
consulted to determine what she perceives to be her most pressing
needs. There may be needs for housing, employment, psychological services, foster placement, medical care, legal assistance,
interpreters, family reunification, or case management (Clawson
& Dutch, 2008). Funds may be needed for removal of tattoos or
brands that the trafficker used to mark the individual as property.
Additional needs arise if the trafficking survivor has children
(Busch-Armendariz et al., 2011).
or constraints on available resources, (c) little communication and
planning between agencies, and (d) a shortage of resources to
evaluate the effectiveness of service provision. There are also challenges in working with law enforcement agencies (Caliber, 2007;
Jones & Yousefzadeh, 2006; Kara, 2007). Farrell et al. (2012) found
that law enforcement officers may be reluctant to expend significant resources in investigating potential trafficking cases if stable
community resources are not available for the survivor. Without
adequate and appropriate services, survivors may be vulnerable to
retrafficking or may view returning to the trafficking situation as
their only option. Brunovskis and Surtees (2007) reported that for
a variety of reasons, including previous negative experiences with
assistance, survivors may not always avail themselves of services
offered. Additional challenges identified in the Caliber (2007) study
were some survivors’ unwillingness to work with law enforcement
and concerns about confidentiality. The lack of research that
Because undocumented immigrants would not normally be
informs effective training and clinical interventions contributes to
eligible to remain in the United States, to find employment, or to
these challenges. Psychological expertise in developing training for
access many services needed by survivors, the TVPA and TVPRA
professionals providing services is greatly needed.
provide some immigration relief through continued presence
50
Prosecution and Partnership
In the United States, investigation of human trafficking violations is undertaken by the Federal Bureau of Investigation (FBI)
and the U.S. Immigration and Customs Enforcement (ICE) at the
federal level and by numerous police agencies at the state and
local levels. The FBI’s Civil Rights Unit handles human traf-
Responding to
Trafficking of Women
and Girls
In an unpublished study of 91 successful prosecutions of human
trafficking involving juveniles, three or more interviews were
needed to establish the necessary rapport for a victim to disclose
her abuse (T. D. Patterson, 2012). Traffickers often create,
encourage, and exploit this distrust of law enforcement to keep
victims from seeking assistance.
ficking investigations involving forced labor and adult sexual
Systemwide factors can also impede the investigation and pros-
exploitation, while its Crimes Against Children Unit manages
ecution of trafficking cases—in particular, ignorance of human
cases involving the sex trafficking of children (FBI, 2012). ICE’s
trafficking, lack of collaboration across sectors, and misidenti-
human trafficking efforts include enforcing border security,
fication of victims as criminals. Lack of knowledge and the need
training for law enforcement, and interagency partnerships and
for training about human trafficking on the part of law enforce-
collaboration (ICE, 2012).
ment, especially at the state and local levels, were identified in
Perhaps the single most common law enforcement strategy in
response to trafficking is to form and rely on joint task forces.
In 2006, the U.S. Department of Justice’s Bureau of Justice
Traffickers often create, encourage, and
exploit this distrust of law enforcement to
keep victims from seeking assistance.
several studies and self-identified within the law enforcement
community (Clawson, Dutch, & Cummings, 2006; Kara, 2007;
Moossy, 2008; Reid, 2010; Zhang, 2011).
The complexity of human trafficking investigations, which may
include a variety of criminal activities such as drug trafficking, organized crime, and sexual assault, makes collaboration
and coordination among a variety of entities and jurisdictions
necessary (Farrell et al., 2008, 2012; Venkatraman, 2003).
Parties must be aware of each other’s respective roles and work
closely together. Unfortunately, the literature suggests this may
Assistance began funding task forces dedicated to the investi-
not always happen. For instance, Clawson, Dutch, and Cummings
gation of human trafficking. These task forces, while federally
(2006) found that most local law enforcement respondents were
funded, are administered by state and local policing agencies
unaware of the role of their federal law enforcement counter-
and typically form partnerships with state, local, and federal
parts in human trafficking investigations, and many were not
agencies, including law enforcement, social service providers,
accustomed to dealing with victims, even when assigned to
mental health providers, and others (Farrell et al., 2012).
a specialized unit. Psychological research on work-team and
In a recent study of law enforcement officers investigating
human trafficking violations (n = 121), 45% reported that
victim distrust was the biggest challenge to identification of and
response to victims (Clawson, Dutch, & Cummings, 2006). The
officers believed that victims’ distrust was due primarily to fear
of deportation, fear of retaliation from the traffickers (toward
the victim or the victim’s family), and a general “lack of trust
multidisciplinary team performance (e.g., Salas, Cooke, & Rosen,
2008) could potentially contribute to more effective collaboration
among joint task force members. Reid (2010) also suggested that
the differences in terminology can hinder cross-jurisdictional
partnership. For example, agents investigating pornography
involving minors may not collaborate with agents who investigate
other forms of CSEC.
in the U.S. criminal justice system” (p. 38). Similarly, Farrell,
Law enforcement agencies’ failure to recognize and distin-
McDevitt, and Fahy (2008) reported that lack of victim cooper-
guish trafficking victims from criminals derives in part from
ation was the most commonly cited challenge to investigating
the tendency to rely on traditional law enforcement tactics and
human trafficking cases, with fear of retaliation and lack of trust
strategies. Conflicts between state laws and the TVPA also
in the criminal justice system as the top two reasons believed
contribute to this failure. For example, in a majority of the 50
to cause noncooperation. Interestingly, Farrell et al. (2008) also
states, a minor’s selling of him- or herself for sex is a criminal
noted that 81% of respondents reported a victim’s fear and lack
offense. This contrasts with the TVPA, which considers all minors
of cooperation as a key indicator of potential human trafficking.
engaged in commercial sex acts as trafficking victims. Further,
51
state statutes regarding prostitution do not distinguish between
adult prostitution and child sexual exploitation and thus criminalize both (Adelson, 2008).
In fact, a 2010 report from the Department of Justice to the U.S.
Congress concluded that “[c]hild victims of prostitution—the
victims of CSE—are more likely to be arrested than are the child
sex traffickers or client sex offenders” (U.S. DOJ, 2010a, p. 34).
Report of the Task
Force on Trafficking
of Women and Girls
Data from 76 law enforcement agencies in 13 states showed
that arrests were made in 74% of 229 cases in which juveniles
were implicated in prostitution incidents between 1997 and 2000
lack of outcome evaluation (Clawson et al., 2009; Laczko &
Danailova-Trainor, 2009; van der Laan et al., 2011). Clawson et
al. (2009) stated that
while respondents reported collecting and reporting these
data as a requirement of their funding, very few indicated
they are using the data to assess their own performance.
Respondents indicated that a lack of resources, limited
capacity, and a lack of technical expertise were key reasons
for not using the data and for the absence of engaging in
formal (or informal) evaluations of their efforts. (p. 41)
(Finklea, Fernandes-Alcantara, & Siskin, 2011). Logan, Walker,
Thus, the field is in need of systematic and rigorous research to
and Hunt (2009) concluded that this misclassification was not
determine what does and does not work in preventing trafficking,
limited to juvenile cases:
in protecting victims, and in prosecuting those engaged in the
U.S. law enforcement personnel … are typically trained to
crime of human trafficking.
focus on perpetrators of crimes. When the trafficked person
is involved in illegal activities such as prostitution or is an
undocumented immigrant, … it may be difficult to define
them as victims rather than just as criminals. Thus, law
enforcement officials often do not look past the criminal
activity to see whether it is part of a larger problem such as
human trafficking, leaving some victims of human trafficking identified only as criminals. (p. 6)
Conclusion
A variety of responses to human trafficking have been suggested
and attempted in the field, but by and large, demonstrably effective anti-trafficking programming has barely begun. As a result of
professional training and community awareness programs, early
identification of human trafficking should increase the chances
Social service agencies also report that lack of information and
that women and girls will receive services (if such services are
training on human trafficking and lack of information about
available) and will be able to escape or exit the trafficking situ-
available referral agencies are barriers to successful service
ation. However, this is insufficient from the standpoint of human
provision (Clawson & Dutch, 2008). Additional complexities arise
rights and justice. Far more attention needs to be directed to
from differences in organizational cultures between law enforce-
primary prevention and to what Strasser (1978) called “primordial
ment and service agencies (Fukushima & Liou, 2012), lack of
prevention” or efforts to correct underlying conditions that enable
familiarity with operating procedures of collaborating agencies,
risk factors to develop in the first place. As others have argued
and unrealistic expectations that may result from these factors
(Farmer, 1999; Rieger, 2007), the root causes of trafficking must
(Clawson et al., 2003; Fukushima & Liou, 2012; Srikantiah,
be addressed, focusing on the structural violence that makes
2007). Differences in how “victim-centered” approaches are
women and girls vulnerable to this crime.9 According to Rieger
defined and whether prosecution or protection should take prece-
(2007, p. 235), “sex trafficking could not thrive if women were not
dence further complicate partnerships.
systematically oppressed and marginalized.” Ultimately, success
will mean providing all that is necessary for women and girls to
live healthy, safe, and free lives.
Program Evaluation:
The Challenge
Responses to human trafficking have developed as needs have
been identified, but they seldom have been guided by a comprehensive understanding of the problem. To date there is a notable
52
THE ROLE OF THE
PSYCHOLOGIST
Psychology can and must address human trafficking in all pro-
educational system that provides a foundation for children from all
fessional capacities: research, education and training, advocacy
communities to have real opportunities for meaningful work at a
and public policy, public awareness, and practice. The issue
living wage and sufficient leisure for healthy lives.
must be addressed at multiple levels of the social ecological
model, from individual protective and risk factors to societal and
policy factors. Whether as independent practice clinicians or as
organizational psychologists, researchers, educators, or members
of integrative health care teams, psychologists are needed to fill
the critical roles that continue to develop within this field.
As a discipline that explores the depth and breadth of human
behavior, psychology is well positioned to study the multiple
intrapsychic, developmental, interpersonal, relational, social,
cultural, religious, educational, institutional, societal, and economic issues that intersect to contribute to the phenomenon of
trafficking. All psychologists have a role to play in eradicating
Furthermore, psychologists engaging in professional capacities
trafficking and are urged to bring scientific expertise to bear on
to address human trafficking must possess competence in
policy, service provision, and an understanding of the dynamics
multiculturalism and diversity that prepares them to attend to
of trafficking. This section explores the variety of roles psycholo-
the intersections of gender, race, ethnicity, language, sexual ori-
gists can play in addressing human trafficking.
entation, gender identity, age, ability, class status, education,
religion/spirituality, developmental stage, and culture (APA,
2008, 2012).
Professional psychology must address the societal factors that
contribute to the trafficking of girls and women, including the
status of girls and women in the United States and other nations,
gender-based violence and abuse, racism and ethnocentrism, and
the sexualization and objectification of women and girls (APA, Task
Force on the Sexualization of Girls, 2010). Psychological expertise is essential to establish more humane and equitable labor
practices, a more just and sustainable immigration system, and an
Research
Psychologists who conduct research, such as those in academic, governmental, nongovernmental, military, and industrial
sectors, have a critical role to play in conceptualizing, designing,
conducting, analyzing, and publishing investigations related to
human trafficking. Research can guide clinical practice, help in
the evaluation of prevention efforts, inform curricular development, and educate policymakers, law enforcement personnel,
community organizers, and the public.
Psychologists can undertake research projects that will lead to a
will all contribute to an understanding of human trafficking and
more nuanced and specific understanding of the individual fac-
its prevention.
tors that may put women and girls at risk of being trafficked. In
addition, attention to factors such as resilience (Cecchet, 2012;
Harvey & Tummala-Narra, 2007; Schloenhardt & Loong, 2011),
spirituality and religious faith (Bryant-Davis, 2005), resistance
Education and Training
to identifying as a victim (Gozdziak, Bump, Duncan, MacDonnell,
Psychologists whose careers focus on education and training at
& Loiselle, 2006), activism (Bryant-Davis, 2005), and posttrau-
the undergraduate, graduate, and postdoctoral level can incorpo-
Report of the Task
matic growth (Bensimon, 2012)—as opposed to exclusive focus
rate the topic of human trafficking into psychology-specific 2 and
Force on Trafficking
on the negative consequences of victimization––may also be
interdisciplinary courses, seminars, and case conferences. 3
of Women and Girls
important in the process of healing and recovery for survivors of
human trafficking (Gozdziak et al., 2006).
Specialized practicum, internship, and postdoctoral training
sites that work with traumatized populations, such as the
Participatory and social action research methodologies that
Cambridge Health Alliance’s Victims of Violence Program, should
include persons who were formerly trafficked or grassroots
be considered. 4 Supervision must be provided by psychologists
organizations as research partners may help address some of the
who are experienced and knowledgeable regarding human
challenges of conducting clinical research with this population.
trafficking dynamics, complex trauma, and the potential for sec-
In particular, identifying potential participants and building
ondary traumatization. Practical experience with organizations
trust with women and girls who are victims of trafficking can be
led by survivors of trafficking would be extremely beneficial for
difficult. Community-based participatory research is a promising
psychologists training to work with this population.
approach to addressing this topic (Israel, Schultz, Parker, & Becker,
1998; Minkler & Wallerstein, 2008; Smikowski et al., 2009).1
Practicing psychologists in most states are required to earn
continuing education credits on a regular basis as a component
As the number of direct-service programs for women and girls who
of license renewal. 5 Psychologists can develop and provide
are victims of trafficking continues to grow, psychologists can
continuing professional education content addressing human
contribute by conducting evaluation and assessment research.
trafficking to assist colleagues and others to expand their
Research on programs that provide street outreach, exiting support,
skills and content expertise.
survivor mentorship, family and community reintegration, legal
advocacy, career counseling, and mental and physical health care
will contribute to evidence-supported practice.
Psychologists can participate in developing culturally sensitive and developmentally appropriate curricula for all levels of
education, as well as for professionals who interact with popula-
Psychologists are well suited to lead interdisciplinary teams as
tions vulnerable to trafficking (e.g., airline and hotel personnel,
they develop research agendas (Sternberg, 2007). Partnerships
emergency room staff, child protection workers, law enforcement).
with scholars trained in other disciplines, such as criminal justice,
Training is critical to improve professionals’ ability to identify and
sociology, international studies, business, women’s studies, public
respond appropriately to trafficked individuals. The Family Violence
health, law, social work, public affairs, human development and
Prevention Fund (2005) reported that 28% of survivors in their
family studies, nursing, medicine, religion, and ethics can further
sample interfaced with health care providers during their captivity,
inform psychologists’ understanding of the complexities of human
yet none were questioned about their situation.
trafficking and also ensure that other disciplines develop a more
comprehensive understanding of the ways in which human behavior
impacts, and is impacted by, social, political, and economic issues.
Finally, psychologists can contribute to the fields of crime prevention, investigation, and prosecution through research regarding
the circumstances, characteristics, and behavioral patterns of
perpetrators. Research on individual traffickers, networks of traffickers, and the demand (e.g., sex buyers) aspects of trafficking
54
Advocacy and Public Policy
Policy may be the most meaningful area to which psychologists
can contribute. Policy has substantial potential to impact both
those identified as trafficked and those at risk for trafficking.
By engaging in education and advocacy at the federal level,
psychologists can share their knowledge of psychological
translate complex research findings into information accessible
science with policymakers to “contribute to the formulation of
to the general public. Their translational skills can specifically
sound public policy to address health and social issues and
support nongovernmental organizations that focus on public
improve human welfare” (APA, 2010b, p. 7). At state and local
awareness and prevention efforts. Expertise offered by community
levels, psychologists can educate their elected and appointed
and social psychologists can also help in developing effective
officials in the state legislature, state agencies, city council,
ways to educate specific audiences.
and school board. All levels—federal, state, and local—would
6
benefit from concise information about at-risk populations, conThe Role of the
Psychologist
tributing factors, means of trafficking, and the consequences of
exploitation for individuals and for communities.
Psychologists also may ground their work with nongovernmental or
nonprofit (501c3) organizations to address gaps that have not or
cannot be met by government agencies. In some cases, agencies
that address youth homelessness, immigrant rights, refugee/asylee
resettlement, intimate partner violence, sexual assault, and child
abuse may also serve trafficked persons. Within the nonprofit community, psychologists who work as social policy researchers also
influence public policy and resource allocation decision making at
all levels of government.
Practice
Psychologists practice in many arenas. Practice areas pertaining
to trafficking may include evidence-based assessment, diagnosis, and treatment of individuals; program development and
evaluation; program and organizational administration; criminal
investigation; consultation; career and educational counseling;
and community organizing. Before engaging in any work related
to trafficked women and girls, psychologists have an obligation
to educate themselves about the complexity of this issue.
DIRECT SERVICE WITH TRAFFICKED WOMEN AND GIRLS
Chung (2005) argued that professional psychologists working
The central challenge of providing psychotherapy services to sur-
with women and girls affected by inequalities and violence must
vivors of human trafficking today is the dearth of clinical research
reexamine their roles and be mindful of social justice and human
identifying best practices for this population. Given that caveat,
rights issues. Psychologists must work from a more holistic and
the following sections refer to interventions and approaches, which
less isolated perspective and strive to understand the impact of
with few exceptions were not developed to work with trafficked
international connectedness to inform their advocacy work.
persons but rather with other trauma-affected populations.
Trauma-informed care. Using a trauma-informed care approach
Public Awareness
Public awareness and understanding of the crime of human
trafficking and the dynamics of coercion and trauma are essential
for the success of any anti-trafficking efforts. Psychologists
interested in informing the public about human trafficking can
to engage women and girls with histories of traumatic experiences
recognizes the presence of trauma symptoms and acknowledges
the role these experiences play in their current concerns and earlier
in their lives (see National Center for Trauma-Informed Care web
page: http://www.samhsa.gov/nctic). 7 This is a paradigm shift
from one that asks “What’s wrong with you?” to “What has happened to you?” This approach changes the way in which services
The central challenge of providing
and supports are organized and delivered and creates opportuni-
psychotherapy services to survivors of
practice is to foster support, healing, and resiliency and to refrain
human trafficking today is the dearth
& Fallot, 2001). Trauma-informed care must attend to contextual
of clinical research identifying best
of trauma survivors (Harvey & Tummala-Narra, 2007). Harvey and
practices for this population.
recovery as “a result of clinical intervention, yes, but also recovery
55
ties for healing and recovery. The intention of trauma-informed
from doing further harm, which results in retraumatization (Harris
and cultural factors and to the individual and collective resilience
Tummala-Narra (2007) emphasized that providers should view
as a result of the many internal and external resources that
trauma survivors are able to craft and call upon in widely diverse
initiated the Task Force on Treatment of Complex Posttraumatic
environments” (p. 2).
Stress Disorder (Cloitre et al., 2011). The goal of that task force
In many parts of the United States, survivors have limited
access to service providers with specialized training in the
psychological needs of trafficking victims (Adams, 2010; Chung,
Bemak, Ortiz, & Sandoval-Perez, 2008; Yakushko, 2009). In addition, trauma-informed psychological services specifically for
Report of the Task
Force on Trafficking
of Women and Girls
this population are still in development and difficult to access
(Clawson, Salomon, & Goldblatt Grace, 2008; Yakushko, 2009). 8
However, there is a wealth of literature describing effective
was to provide guidance for practicing clinicians and other
health professionals on the treatment of complex posttraumatic
conditions resulting from repetitive and chronic interpersonal
trauma over the lifespan, which is related to the pervasive polyvictimization of trafficked women and girls. As evidence-based
treatments specifically geared toward trafficked women and
girls are evaluated, there will be opportunities to revisit treatment guidelines to continue to improve the provision of services.
and empirically based interventions with survivors of trauma
Treatment considerations. Before providing treatment to
(Cook et al., 2005), and as long as the gap in development of
trafficked women and girls, psychologists have an obligation to
gain competency regarding this population’s unique constellation
Before providing treatment to trafficked
of mental health problems. The overarching stance that treating
women and girls, psychologists have an
rights perspective (Bemak, Chung, & Pedersen, 2003), addresses
obligation to gain competency regarding
unique needs of the various ethnic and racial groups affected by
this population’s unique constellation of
A. Banks (2006, 2011) proposed using psychotherapies that
mental health problems.
psychologists need to adopt is one that integrates a human
the particular needs of women and girls, and is sensitive to the
this crime (Clawson, Dutch, & Williamson, 2008).
foster the development of mutual and growth-promoting relationships. Psychotherapies that emphasize the role of the therapeutic
relationship can change brain structures and functions respon-
interventions specific to trafficked women and girls exists, it
is reasonable to recommend current guidelines applied to the
survivors of other abuses.
sible for mental illness (Fuchs, 2004), including dysfunctional
neurocircuits contributing to major depression and PTSD (Peres
& Nasello, 2008). Because traffickers use and abuse the human
need to connect with others, and because depression and PTSD
Developmental and cultural considerations remain paramount in
are both consequences of trafficking, such formulations hold
creating trauma-informed therapies with trafficked women and
promise for therapy with trafficking survivors.
girls. Additionally, Harvey and Tummala-Narra (2007) recommended
a stronger focus on the role of resiliency and other individual and
contextual factors that mediate recovery from trauma.
Herman’s (1992) stages of recovery model to address PTSD
and complex PTSD has potential for working with trafficking
survivors. Herman’s recovery model includes three stages:
Psychologists working on complex trauma and complex PTSD
establishing safety, remembrance and mourning, and reconnec-
issues can continue to inform and enhance an understanding
tion with ordinary life. The first stage is essential; according to
of best practices and effective interventions (Cloitre et al.,
Herman, recovery cannot progress if safety is not established
2011; Courtois, 2008). Working in conjunction with trafficked
and maintained. Remembrance and mourning involve narrative
women and girls to develop appropriate and effective therapeu-
work, with the survivor relating the trauma experience in depth
tic techniques is essential. Practicing psychologists can also
until the memory is transformed and integrated into her life
develop diagnostic, evaluation, and treatment guidelines, which
story. In the final stage of recovery, the survivor faces the chal-
describe professional competencies and prescribe ethical and
lenge of “creating a future” by developing new relationships,
responsible care of the individuals they serve. A good example is
new learning, new belief systems, and “reclaiming her world”
APA’s Division 56 (Trauma Psychology), which, in collaboration
(1992, p. 196).
with the International Society for Traumatic Stress Studies,
56
Other models address the needs of women in CSE who are at
factors that can contribute to entering prostitution 10 as opposed
different stages of the exiting process (L. M. Baker et al., 2010;
to exclusive attention to preventing HIV infection. 11
Dalla, 2006). L. M. Baker and colleagues proposed an integratedstage model of exiting prostitution on the basis of their own
work with women in street-level prostitution and on four earlier
models: Prochaska, DiClemente, and Norcross’s transtheoretical
(1992) model; Fuchs Ebaugh’s (1988) role exit model; Månsson
and Hedin’s (1999) exit model; and Sanders’s (2007) typology
Addressing disordered family dynamics is an important aspect
in prevention of trafficking; it is an essential component in the
healing process to prevent revictimization. Working with youths on
peer relationships and issues of interpersonal violence can also
serve protective purposes.
The Role of the
of transitions. Individual differences must be recognized in any
In addition to treating survivors, psychologists can play a role in
Psychologist
model focused on exiting CSE; like the experience of traffick-
meeting the needs of affected families and communities, espe-
ing itself, the reasons and readiness for escaping CSE and the
cially during the course of family reunifications and community
subsequent needs for services and support will vary from one
reintegrations. Whether the woman or girl was victimized in
individual to another (Dalla, 2006; Williamson & Folaron, 2003).
labor- or sex-trafficking situations, she likely was separated from
Understanding the varying degrees of cognitive and emotional
family and friends. There may also be barriers to reestablishment
readiness to leave and the many barriers to exiting across the
of those relationships, particularly if the survivor was trafficked
stages can help therapists working with women and girls as they
into the United States and needs to cooperate with the investiga-
seek to remove themselves from exploitation.
tive and prosecutorial process to receive government assistance.
The harm reduction approach, originally applied in treatment
and prevention of addictions, has also been used with CSEC
survivors and in HIV/AIDS and violence prevention projects with
Barriers to reestablishing relationships may also exist if the family and community shame, blame, or shun the trafficked person
or if the family was the origin of the trafficking.
CSE adults (Harm Reduction Coalition, n.d.; Iman, Fullwood, Paz,
Psychologists with expertise in complex systems can also consult
Daphne, & Hassan, 2009; Marlatt, Larimer, & Witkiewitz, 2012;
with service providers about the importance of social support in
Pierce, 2012; Rekart, 2005). This nonjudgmental approach
the process of exiting CSE and the relational factors that can be
facilitates outreach and helps maintain connections to popula-
barriers to exiting (L. M. Baker et al., 2010). These can include
tions that might be suspicious of service providers’ intentions,
limited formal and informal support, strained family relations,
such as homeless and runaway youths or adults involved in illegal
social isolation, and problems created by existing relationships
activity. This method addresses the complexities of decision
with pimps and drug dealers (L. M. Baker et al., 2010).
9
making and the ways in which unequal power exploits relationships. Additionally, for individuals not yet able or ready to exit
commercial sex (e.g., at earlier stages in the model proposed by
L. M. Baker et al., 2010), the harm reduction approach offers protective health services for reducing risk of contracting infectious
diseases, including HIV, and maintains an open connection with
service providers who can serve as resources when individuals are
ready to leave the trafficking situation.
The needs of trafficking survivors are extensive and complex,
requiring a holistic approach to services (Chung, 2009; Shigekane,
2007; Yakushko, 2009). Trafficked women and girls are exposed to
high levels of physical deprivation, injury, and violence that may
result in physical and cognitive disabilities needing specialized
rehabilitation services. Psychologists can serve on interdisciplinary
rehabilitation teams (Yakushko, 2008, 2009). Concurrent treatment
for physical and mental health symptoms is optimal. The role of
An important critique of the harm reduction model applied to
culture in symptom experience and service seeking may further
CSE is the extensive harms that are not addressed. There is no
complicate service provision. Developmental factors must also be
question that HIV, STIs, and addictions require nonjudgmental
considered. Psychologists must be competent in identifying soma-
treatment and prevention. However, many HIV/AIDS prevention
toform disorders; because of the interaction of trauma, gender, and
programs for sex workers do not screen for trafficking or indicate
culture, some women and girls may present with multiple medical
that engagement in commercial sex is anything other than a free
problems rather than articulate them as mental health concerns
choice. Harm reduction programs focused on CSEC victims (Harm
(Chung, 2009; Williamson et al., 2010).
Reduction Coalition, n.d.) instead work on reducing the risk
57
Report of the Task
Force on Trafficking
of Women and Girls
Issues of trust and betrayal are pervasive with trafficked women
Second, health care professionals can provide essential services
and girls; therefore, it is critical that psychologists fully under-
in addressing health care needs that are emergent or that may
stand their professional responsibilities and limitations in regard
be chronic and have been neglected (Barrows & Finger, 2008).
to confidentiality and mandatory reporting of child maltreatment.
The International Organization for Migration (2009) provides
Clawson, Salomon, and Goldblatt Grace (2008) recommended
an excellent resource for health care providers that covers such
that professionals refrain from promises of confidentiality that
topics as what to do if a provider suspects trafficking; providing
they may not be able to keep, particularly with youths.
culturally appropriate, trauma-informed care and working effec-
Other challenges to providing psychological services include
language and cultural barriers (Orhant, 2002; Zimmerman et al.,
tively with interpreters; and identifying and treating potential
acute and chronic mental and physical health needs.
2003); shame and stigma about mental health services (Chung
Burnette et al. (2008) found that women with a lifetime history
et al., 2008; Miller et al., 2007; Shigekane, 2007); avoidance
of prostitution reported using emergency department services
issues and security concerns (Shigekane, 2007); the criminal-
(44.6%) more than any other form of health care service.
ization of CSE women and girls (Judge & Murphy, 2011; Kurtz,
Psychologists can assist with training emergency department
Surratt, Inciardi, & Kiley, 2004); and barriers to accessing other
personnel to increase early identification of trafficked women
services, such as shelter and transportation (Alexander et al.,
and girls and referrals for services.
2005; Boyer, 2008; Miller et al., 2007; Zimmerman et al., 2003).
Each of these challenges is exacerbated by limited clinical
research to guide program developers and clinicians in offering
effective services.
Other areas of practice. School psychologists and other psychologists who work with children and youths can educate themselves
about human trafficking risk factors and vulnerabilities––such
as early exposure to violence, abuse, or neglect—to develop tools
Victim identification. Keeping in mind that human trafficking
to identify high-risk situations and individual vulnerabilities to
and other victimizations are not necessarily mutually exclu-
human trafficking and to provide early intervention. School psy-
sive, clinicians must have the knowledge base to differentiate
chologists can also provide training to teachers, administrators,
human trafficking from other situations that share many of the
and other school personnel to help them identify at-risk children
same dynamics (e.g., intimate partner violence). Violence in a
and their families.
relationship may mask evidence of force, fraud, or coercion—key
indicators of human trafficking. Similar issues of miscategorization may arise with childhood sexual abuse or with delinquent
behaviors. Unless screening questions are asked, sex and labor
trafficking can remain invisible. 12
Within criminal justice systems, psychologists can play key roles
by assisting in victim interviews and evaluations. Forensic
interviewers are uniquely trained to bridge the sensitive needs
of trauma victims with the needs of law enforcement officials
and members of the court who seek to prosecute traffickers.
Barrows and Finger (2008) highlighted that health care pro-
Herman (2003, 2005) addressed the advantages and challenges
fessionals have two key roles to play. First, they are likely to be
of mental health provider involvement in criminal cases. Issues of
on the front line for potentially identifying victims if they have
confidentiality, consent, and establishing who the client is (law
adequate training about indicators of trafficking. Factors such
enforcement, attorneys, or the survivor) become critical issues for
as tattoos that indicate “property” (e.g., bar codes, the pimp’s
professional discernment.
13
name), lack of identification documents, or reluctance to speak
in the presence of the person accompanying them may indicate
trafficking but could also indicate any number of other situations, including entirely innocuous ones. However, if there is a
suspicion that the person may be controlled, it is essential to
provide an opportunity to consult with that individual privately,
using protocols similar to those used in possible intimate partner violence situations.
Training in psychology and forensic interviewing must be supplemented with information regarding the dynamics of victimization
in human trafficking. For example, without an understanding of
the multiple traumas experienced by trafficked women and girls
and the lengthy process of recovery, an interviewer may mistakenly characterize a crime victim as “uncooperative in her own
treatment” rather than as having been conditioned by her captors
to fear the authorities. Trafficking survivors well advanced in
their recovery process can provide invaluable assistance to
58
psychologists and forensic interviewers in their efforts to understand these dynamics and protect against retraumatizing the
client (Pierce, personal communication, April 29, 2013).
Milton Erickson used to say to his patients, “My voice will
Psychologists may also serve as expert witnesses in court
proceedings. Social psychologists can provide valuable testimony
to help jurors and judges understand the psychological mech-
Psychologist
go with you.” His voice did. What he did not say was that
our clients’ voices can also go with us. Their stories become
part of us—part of our daily lives and our nightly dreams.
anisms by which people can be coerced and manipulated and
The Role of the
Self-Care and Safety:
Ethical Considerations
Not all are negative—indeed, a good many are inspiring.
their freedom constrained. This can be done by addressing the
misperception that trafficking victims “could have left” because
they may not have been physically constrained or that the victim
The point is that they change us. (Mahoney, 2003, as cited
in Meichenbaum, 2007, p. 3)
is a “bad witness” based on her behavior and demeanor. Clinical,
Psychologists working with trafficked individuals, in whatever
forensic, developmental, and child psychologists can speak to
capacity—direct service, consulting, policy work, research—
need to pay special attention to their own well-being (IOM,
Psychologists working with trafficked
2009; Kliner & Stroud, 2012). Research indicates that providing
individuals, in whatever capacity—
ing, with roughly 50% of professionals reporting distress and
direct service, consulting, policy work,
Meichenbaum, 2007). Distress can fuel burnout, secondary trau-
research—need to pay special attention
fatigue (CF). Because of the level of trauma experienced by traf-
to their own well-being.
be particularly mindful of their personal mental health.
trauma-focused treatment is emotionally complex and demandapproximately 30% reporting extreme distress (Figley, 2002;
matic stress (STS), vicarious traumatization (VT), and compassion
ficked persons, psychologists working with this population need to
Burnout, STS, VT, and CF are interrelated yet different. Burnout
can occur regardless of the type of work or population served.
the impact of complex trauma on child and adult behavior in
However, STS, VT, and CF result from work with traumatized indi-
a way that would help the court understand the impact of the
crime. For example, forensic psychologists may use psychological
evaluation methodologies and tests to illuminate the psychological conditions created as a result of trafficking and its impact on
functioning and recovery. In addition, psychologists can evaluate
the terms are frequently used interchangeably (Meichenbaum,
2007; Smith & Moss, 2009):
• Burnout
can result from prolonged exposure to a work environment that is not supportive yet has high demands. This causes
persons receiving benefits under the TVPA, provide treatment
exhaustion, depersonalization, and a sense of reduced personal
recommendations to multidisciplinary teams, or explain documents for an attorney to use in support of a T-visa application.
viduals. While some authors differentiate the three conditions,
14
Psychologists working as administrators may oversee health care
delivery systems, supervise clinical training of future psychologists, or directly influence service delivery and care received by
effectiveness and accomplishment (IOM, 2009; Jenaro, Flores, &
Arias, 2007; Kliner & Stroud, 2012; Meichenbaum, 2007; Perron &
Hiltz, 2006; Smith & Moss, 2009).
• Secondary
traumatic stress is similar to PTSD but results from
clients and patients. These psychologists are particularly well
knowledge of trauma experienced by another person (Figley,
suited to address the complex needs of survivors, which require
2002; IOM, 2009; Kliner & Stroud, 2012; Perron & Hiltz, 2006;
an array of coordinated multimodal responses from diverse
Smith & Moss, 2009; Yassen, 1995); the trauma could result from
sectors, ranging from mental health, medical, and social services
a single traumatic event or from multiple or persistent trau-
providers to law enforcement, attorneys, and other representa-
mas. Symptoms of STS may include heightened arousal, intrusive
tives of the law (Miller et al., 2007).
images and thoughts, avoidance, numbing, somatic complaints,
and nightmares and sleep disruption (IOM, 2009; Kliner & Stroud,
2012; Smith & Moss, 2009).
59
• Vicarious
traumatization, like STS, results from interaction with
traumatized persons (McCann & Pearlman, 1990) and perma-
to prevent and mitigate impairment in their work (see, e.g., APA
nently alters the lens through which an individual perceives the
Ethics Code, 2002, 2010a; E. K. Baker, 2003; Barnett & Cooper,
world and self (Meichenbaum, 2007). In particular, VT impacts
2009; Carroll, Gilroy, & Murra, 1999; Good, Khairallah, & Mintz,
an individual’s sense of safety and ability to trust others.
2009; Meichenbaum, 2007; Norcross & Barnett, 2008; P. L. Smith
• Compassion
fatigue has been described as “a form of caregiver
burnout among psychotherapists” (Figley, 2002). Compassion
Report of the Task
Force on Trafficking
of Women and Girls
the therapeutic relationship; and (c) engage in self-care measures
fatigue is one potential manifestation of STS and may be
experienced as preoccupation with the traumatized client and
reduced empathy, numbing, distancing, or avoidance. Adams,
Boscarino, and Figley (2006) developed a scale to measure CF,
which includes elements of burnout (“I have a sense of worth-
& Moss, 2009).15 Without awareness of these hazards and without
adequate individual and organizational measures to maintain
psychological and emotional health, psychologists run the risk of
compromising their effectiveness and retraumatizing their clients.
Barnett and Cooper (2009) argued that self-care is an “ethical
imperative” and should “be seen as a core competency for psychologists” (p. 17).
lessness, disillusionment, or resentment associated with my
Self-care is a dual responsibility. It should be practiced by indi-
work,” “I have felt trapped in my work”) and STS (“I experience
vidual psychologists but also must be supported through orga-
troubling dreams similar to those of a client of mine,” “I am
nizational and supervisory actions. Individual activities include
losing sleep over a client’s traumatic experiences”).
maintaining a healthy balance between work and personal
Psychologists with a personal history of trauma are more vulnerable to burnout, STS, VT, and CF (Meichenbaum, 2007). Additional
factors that can increase the possibility of these conditions are
insufficient training, education, or experience; demanding workloads; and psychosocial stressors (Barnett, 2008; Kliner & Stroud,
2012; Meichenbaum, 2007). Protective factors include supportive work environments, adequate training and supervision, job
autonomy, and self-care (Barnett, 2008; Barnett & Cooper, 2009;
Kliner & Stroud, 2012; Meichenbaum, 2007; Smith & Moss, 2009).
Although U.S. studies on the consequences of working with trafficked persons are not available, international literature indicates
negative impacts on providers’ physical health, psychological
health, work, and personal lives (IOM, 2009; Jung et al., 2008;
Kliner & Stroud, 2012). Jung et al. (2008) found that anti-trafficking activists in Korea presented with high rates of somatization,
fatigue, depression, and frustration. Health and social care staff
working with survivors of sex trafficking in the United Kingdom
reported a number of problems, including sleep disturbance,
somatic pain, and physical and emotional exhaustion (Kliner &
Stroud, 2012). Kliner and Stroud (2012) reported that “many of
the participants described their work as heavily impacting their
personal life” (p. 12).
Psychologists who provide direct services to clients have an ethical
responsibility to (a) be cognizant of the possibility of burnout, STS,
VT, and CF; (b) understand the impact these conditions have on
60
life; getting adequate sleep, nutrition, leisure, and exercise;
employing strategies to heal, relax, and self-soothe; 16 alerting
supervisors or colleagues if additional support or a change in
caseload is needed; seeking social support; and participating
in personal psychotherapy (Barnett & Cooper, 2009; Good et al.,
2009; Meichenbaum, 2007; Smith & Moss, 2009). It is also
recommended that psychologists seek additional training, supervision, and educational opportunities to ensure their competence
in areas that are new or challenging (Smith & Moss, 2009).
Supervisors, managers, and organizations that educate or employ
psychologists also have an ethical responsibility to promote “a
culture of self-care” (Barnett & Cooper, 2009, p. 16). First and
foremost, this includes honest acceptance that STS, VT, and CF
can occur and that measures should be taken to reduce their likelihood and to address them when they arise. Recommendations
include training about STS, VT, CF, and burnout for graduate students in psychology and as continuing education for practitioners
(Barnett & Cooper, 2009; Good et al., 2009; Smith & Moss, 2009).
Organizations need to provide culturally sensitive, high-quality
supervision, mentorship, and careful management of caseloads
(Kliner & Stroud, 2012; Meichenbaum, 2007). If a provider has a
disproportionate number of severely traumatized clients, burnout
is likely and there is increased risk for STS, VT, and CF.
Most important, integrating self-care norms into psychology education and practice will provide both preventative and restorative
1. Do no harm.
benefits for practitioners who deal with trauma on a frequent
basis (Barnett & Cooper, 2009; Good et al., 2009). Leadership in
2. Know your subject and assess the risks.
training programs and practice settings must promote a culture
3. Prepare referral information—Do not make promises
in which a balance between work and personal life is encouraged.
Self-care activities must be reinforced rather than penalized or
disparaged, and honest communication about personal distress
4. Adequately select and prepare interpreters, and coworkers.
and the need for collegial support must be encouraged (Barnett
5. Ensure anonymity and confidentiality.
& Cooper, 2009; Good et al., 2009; Meichenbaum, 2007; Smith &
The Role of the
Moss, 2009).
6. Get informed consent.
Psychologist
Good et al. (2009, p. 21) argued that psychologists “tend to view
wellness and impairment in dangerous dualities,” casting care
providers as healthy and knowing and clients as impaired and
needing care. Good et al. warned that such dualistic thinking
can keep practitioners from recognizing or admitting when they
are depleted or need support and care. Just as such thinking can
be harmful to the provider, it can also keep psychologists from
recognizing the strengths, resilience, and resources of the clients
they serve.
you cannot fulfill.
7. Listen to and respect each woman’s assessment of her
situation and risks to her safety.
8. Do not retraumatize a woman.
9. Be prepared for emergency intervention.
10. Put information collected to good use.
For the safety of providers, agency staff, and clients, clear guidelines should be developed for confidentiality protocols, employee
Given the trauma associated with human trafficking, individual
responsibilities, building security, emergency communication and
psychologists and organizations that provide services must proac-
planning, and staff education and training.
tively prepare for the impact of this trauma. Awareness, education,
ongoing self-care, and a supportive work culture are essential to
the well-being of psychologists and to the responsible and effective treatment of trafficked persons.
SAFETY CONSIDERATIONS
Psychologists who work with trafficked women and girls need
to be mindful of safety for their clients, for themselves, and for
their places of work. Concerns for the safety of the client are
heightened if the trafficker is under criminal investigation or
prosecution (IOM, 2009). Maintaining absolute confidentiality
about clients who have been trafficked is essential to client safety
(IOM, 2009). The IOM also recommends that providers listen
carefully to trafficked clients, without pressing them to divulge
details: “Careful listening is an essential security tool in cases of
trafficking. … Trafficked persons are often in the best position to
know of and interpret any dangers they may face” (2009, p. 90).
Zimmerman and Watts (2003, p. 4) provided excellent guidelines for
interviewing trafficked women and girls that capture the essential
need for ethical, respectful, and safe interactions. The guidelines
are intended for service providers and researchers working with this
population as well as media professionals. A full explication of their
recommendations is beyond the scope of this report, but the 10
guiding principles are:
61
RECOMMENDATIONS
The Task Force on Trafficking of Women and Girls offers specific
• Recognize
that no “one-size-fits-all” approach exists to
recommendations in the following topic areas: research, prac-
comprehensively address the victim/survivor experience.
tice, education and training, public policy, and public aware-
No single law enforcement or victim services protocol will suffice
ness. In addition, the task force offers general recommendations
in every case. Remaining flexible with regard to conceptual-
that transcend the topic areas and are essential to all aspects
ization is a critical skill given the many possible intersections
of work in psychology.
of victim characteristics (minor or adult, domestic or foreign
national, among others), as well as the multiple labor and commercial sex settings in which trafficking occurs.
General Recommendations
It is recommended that psychologists:
• Examine
their assumptions and biases toward at-risk groups as
• Acknowledge
that their work occurs within a social ecological system that includes larger community and cultural
influences and that changes in one level of the system may
have wider implications.
they consider engaging in work on human trafficking issues.
Psychologists should remain aware that psychological
Stereotypes related to immigrants and undocumented migrants,
approaches do not exist in a vacuum. For example, policy change
runaway or homeless youths, persons with addictions, or
in the name of anti-trafficking efforts may create unintended
individuals in prostitution can impede identification of human
consequences for other vulnerable communities (such as clients
trafficking survivors and their unique needs.
of child welfare systems or immigrants).
• Be
culturally sensitive in all endeavors related to human
• Support
the creation of cultural shifts among law enforce-
trafficking (research, education and training, advocacy and
ment and service providers in anti-trafficking efforts
public policy, public awareness, and practice).
to create a greater understanding of and respect for all
• Remain
cognizant that internationally and domestically trafficked persons are a diverse and multicultural group.
Psychologists must be able to adapt their professional work
accordingly.
trafficked populations.
For example, community and social psychologists can address
law enforcement and service provider attitudes toward marginalized populations as groups “worthy” of support and access to
methodologies be developed and conducted in collabservices by providing specialized training regarding the nature of • Research
trafficking and its victims.
• Examine
the impact of paternalistic attitudes and the “rescue”
approach on survivors’ outcomes and well-being.
This approach must be guarded against in U.S. policy, NGO programs, and individual treatment. Paternalistic attitudes toward
survivor inclusion in policymaking, program planning, and proRecommendations
gram evaluation sideline expertise and silence essential voices.
for survivor-centered, survivor-informed, and survi• Advocate
vor-led efforts guiding policymaking, protocol development,
research design, methodology, and clinical approaches.
For example, community-based research should be conducted
with the input of affected individuals, taking time to build and
maintain trusting collaborative relationships.
• Increase
focus on prevention of human trafficking at all
levels of the social ecological system.
• Support
recommendations of the APA Task Force on the
oration and consultation with survivors and clinicians who have
substantial experience providing services to this population.
Trafficked persons who have experienced powerlessness may
perceive research settings that are inherently hierarchical to be
overpowering. Therefore, mixed methodologies (e.g., qualitative and quantitative with an overarching participatory action
research lens) may be better suited to concurrently obtain
empirically supported results while paying attention to important ethical concerns.
• Community-based
participatory research be considered as
one promising approach to addressing this topic.
It is recommended that research be conducted in the
following areas:
PREVENTION/DEMAND
• Prevention
of human trafficking at all levels of the social
ecological model.
Sexualization of Girls (2010) regarding social norms, attitudes,
This includes examining risk factors such as child sexual abuse,
and culture of tolerance for sexual exploitation.
child neglect, parental abandonment, racial and ethnic discrimination, homelessness, and marginalization due to sexual identity,
sexual orientation, disability, or immigrant status.
Research Recommendations
To address the limitations of the current research base as
discussed at length in this report, particularly the absence of
research on trafficking of women and girls for forced labor, of
women and girls into and within the United States, and on the
efficacy of programs and treatment modalities for survivors, it is
recommended that:
• The
complexity of human trafficking issues be addressed with
an interdisciplinary and multisector response.
Transnational and domestic trafficking of women and girls
occurs within systems of global and domestic trade, voluntary
• Role
that objectification of women and girls plays in the
proliferation of human trafficking and in fueling the demand
for commercial sexual exploitation.
of women’s empowerment, equity, and rights in the
• Role
prevention of trafficking.
• Potential
role of religion and religious practices in relation
to trafficking recruitment and recovery.
• Effective
cross-disciplinary collaboration and partnerships
for prevention.
• Consumer
and business models for reducing demand for
and forced migration, economic disparities, and structural
products made with forced labor and factors impacting con-
inequalities. In addition, legal and governmental factors such
sumer attitudes and behavior.
as the existence or lack of labor laws, criminal justice procedures, and child welfare systems impact trafficking situations.
The complexity of the issue requires a multisector response, and
interdisciplinary research is necessary for that response to be
optimally effective.
• Effectiveness
of primary prevention efforts targeting girls
and women.
• Link
between pornography and sex trafficking, including trafficking for the purpose of producing pornography, the use of
pornography by traffickers, and the potential for pornography
to fuel trafficking via increased demand.
63
Anecdotal evidence suggests traffickers may use pornography to
“train”
women and girls for commercial sex work and also as a
criminal justice responses, mental health treatment, and
material involving the victim if she does not comply).
rehabilitation and reentry protocols applied to sex offenders
ers of goods and services that involve trafficking, especially
commercial sex.
Force on Trafficking
of Women and Girls
(e.g., rapists, child molesters) to determine whether current
coercion method (e.g., threatening to show family the pornographic
• Demographics,
characteristics, and motivations of consum-
Report of the Task
• Comparison
of sex traffickers to other types of sex offenders
• Demand
and trafficking.
Psychologists can collaborate with groups that work on rehabilitating consumers of commercial sex to build methodologies that
contribute to an understanding of demand in the United States.
IDENTIFICATION
• How
information processing, social perception, schemas,
are appropriate for sex traffickers.
• Degree
to which formerly trafficked persons engage in the
trafficking of others and the determinants of this behavior.
TRAFFICKED PERSONS
• Interactions
of situational and individual characteristics (e.g.,
developmental, cultural, demographic) as they apply to human
trafficking vulnerability, resistance, resiliency, and recovery.
• Post-trafficking
social support and relationships.
Because traffickers commonly prey on women and girls by estab-
and labeling impact the ability of professionals to identify
lishing a trusting, albeit false, relationship with them, studies on
perpetrators and victims of human trafficking in the field and
the impact of trafficking on relationships will be especially helpful.
to respond appropriately.
• Better
understanding of common contributing factors regard-
• Long-term
impact of the trafficking experience throughout
the life course of survivors.
ing areas that may involve trafficking but have not been
For example, the impact of prolonged exposure to violent pornog-
examined as such (e.g., survival sex, stripping, pornography).
raphy or of forced abortions on survivors’ sexual and reproductive
health warrants investigation.
BIASES
• How
depictions of human trafficking impact justice for and
empowerment of survivors.
Depictions may impact how victims perceive themselves (including whether they identify as victims of a crime) and how the
justice system responds (e.g., jury perceptions and decisions,
prosecutors’ willingness to take cases, assumptions about “good
• Overlap
of intimate partner violence and sex trafficking.
• Impact
of gender nonconformity and gender fluidity on vulnerability to trafficking.
• Trafficking
of men and boys for labor and for commercial sex.
• Religious
and spiritual factors pertinent to trafficking (e.g.,
witnesses” and “good victims,” and judges’ rulings). Failure to
risk and recruitment), survivor resilience and recovery, and
represent the diversity of trafficking situations or to recognize
service delivery (e.g., how the faith orientation of groups
the resiliency and agency of trafficking survivors may impact how
providing services impacts the well-being of survivors).
services are provided. This could include examination of depictions of trafficking in the media, government-produced public
service announcements, outreach materials, and NGO logos and
TRAUMA
• Types
of trauma exposure during and after trafficking, with
websites. It could also be fruitful to examine the language of
specific focus on exposure to psychological and physical
policy and rhetoric in the anti-trafficking movement.
coercion, resulting sequelae, and areas of functioning that
are impacted.
TRAFFICKERS
• Trafficker
coercion tactics, especially psychological tactics.
• Typology
of traffickers, including characteristics and contributing factors (e.g., factors that determine whether people
become traffickers).
64
• Trauma’s
impact on decision making, willingness to cooperate with law enforcement, willingness to receive services,
and vulnerability to revictimization.
• Traumatic
bonding, or Stockholm syndrome, in cases of
human trafficking.
• Factors
that reduce the risk of trauma-related sequelae in
affected populations (e.g. resilience of trafficked persons).
• Impact
of developmental variables on treatment choice
and success.
LABOR
• Risk
factors for trafficking into domestic service, agricultural production and meat processing, service industries
Recommendations
Practice Recommendations
(e.g., salons, restaurants, hotels), and other locations of
As practitioners, psychologists perform critical services by provid-
labor trafficking.
ing direct treatment, developing treatment protocols, and
effects of slavelike and exploitative
• Biopsychosocial
work environments.
A thorough examination of the experiences of persons trafficked
for labor, including psychological impact and health consequences, is lacking in the current literature.
• Public
attitudes about and media depictions of labor trafficking.
It would be informative to examine factors contributing to the
consulting with organizations/businesses regarding trafficked
women and girls. The task force recommends that to address the
unique needs of trafficked persons competently, psychologists:
• Develop
more effective screening tools for therapists, social
service providers, law enforcement personnel, health care
providers, and other professionals who may encounter victims.
• Consider
comprehensive and coordinated community-level
relatively low profile of labor trafficking in research, academic
responses in supporting victims and survivors.
writing, and public discourse.
Psychologists are encouraged to develop and maintain partnership protocols with law enforcement personnel, social workers,
PROGRAM AND TREATMENT EVALUATION
• Program/practice
evaluation using randomized control
designs and quasi-experimental designs when appropriate
and ethical.
• Strengths,
limitations, and successes of organizations with
and victim service networks (depending on the needs and
request of survivors) to help streamline and support efficient
community response.
• Strive
for partnership with and coordination of efforts
between protection, prosecution, and prevention sectors. survivor leadership and survivors on staff or as peer mentors.
For example, service providers and law enforcement personnel
It is essential to determine factors contributing to successful
can coordinate their efforts to support survivors more efficiently.
models and to identify best practices, as the number of service
agencies is growing rapidly.
• Development
and evaluation of successful exit programs and
support programs.
• Development
and evaluation of appropriate individual and group
treatments to address the psychological impacts of trafficking.
Group therapy has been used effectively in some programs (Ward
& Roe-Sepowitz, 2009), but anecdotal evidence suggests support
groups may be less effective with some populations because of
the circumstances of their trafficking (Shigekane, 2007). Further
exploration is needed.
• Protocols
for meeting needs of trafficking victims (i.e., shel-
• Apply
psychological theories of healthy personality and identity development, thriving, and psychological growth during
the recovery process for survivors of trafficking.
• Educate
themselves about developmental factors that impact
trafficking risk, response to the trauma of trafficking, and
efficacy of treatment with different age groups.
• Assist
the companies with which organizational psychologists
consult through technical assistance and training, implementation of prevention strategies, and development of business
models for monitoring subcontractors, recruiters, supply
chains, and other practices that may conceal trafficking.
Of special interest are companies that outsource services
ter, health care, trauma-focused counseling, substance use
where trafficking is more prevalent (e.g., hired cleaning crews,
counseling, education, job training, etc.), including guidance
subcontracted construction labor, suppliers of manufactur-
on how to prioritize and provide treatment needs in the most
ing components). In addition, in settings where traffickers or
efficient and cost-effective way.
trafficked persons might be encountered (e.g., airports, hotels,
65
border customs checks, emergency rooms), psychologists are
“too-good-to-be-true” offers; and (e) encouraging critical dis-
encouraged to consult with personnel to increase identification
cussion of the glorification of pimp culture, sexualization of girls
and awareness of trafficked persons.
and women, and demand for commercial sex.
of graduate departments of psychology, chairs of
avenues for practitioner self-care and support self-care • Chairs
• Identify
for other professionals involved in anti-trafficking work (law
departments in related disciplines (e.g., law, social work,
enforcement, service providers, health care, educators, etc.).
public health, public policy, human development and family
In addition, it is recommended that APA make the Report of
Report of the Task
the Task Force on Trafficking of Women and Girls available
Force on Trafficking
to all practitioners to familiarize them with consequences of
of Women and Girls
being trafficked and treatment recommendations relevant to
trafficked persons.
studies, criminal justice), as well as other relevant professionals or community partners, be encouraged to use
information from the Report of the Task Force on Trafficking
of Women and Girls in curriculum development and to aid in
the dissemination of the report.
• The
importance of and ethical imperative for self-care be
emphasized in course work and training.
Education and Training
Recommendations
To increase knowledge and awareness of trafficking, specifically its prevalence and devastating consequences, within the
discipline of psychology and among psychologists, the task force
recommends that:
theory and research be used to develop
• Psychological
effective communication materials and training curricula to
maximize learning among multiple sectors that interface with
trafficked persons or are involved in prevention efforts.
• Psychologists
who supervise practicum students, interns, or
postdoctoral residents be well versed in and have extensive
knowledge of human trafficking.
• A continuing education and online program be developed
using information from the Report of the Task Force on
Trafficking of Women and Girls, in collaboration with APA’s
Office of Continuing Education in Psychology.
• All
curricula and communication materials be developed by
professionals with appropriate background in and knowledge
of trafficking and be evaluated for effectiveness.
This would include service providers, policymakers, law enforcement personnel, health care professionals, businesses, educators,
and others.
• Research
on information processing, social perception,
schemas, and labeling be used to address misperceptions and
failures of identification of trafficked persons.
This research should also be incorporated into training curricula.
• APA
disseminate the Report of the Task Force on Trafficking
of Women and Girls to school psychologists, educators,
and faculty at the elementary, middle-school, high-school,
and undergraduate levels and to chairs of graduate departments of psychology. School psychologists and educators need to be informed about
(a) identification of students at risk for trafficking; (b) fortifying those at-risk youths with skills to withstand manipulation
and advances; (c) empowering youths to recognize and value
Public Policy Recommendations
To promote deeper understanding of all aspects of trafficking of
women and girls, the task force recommends that psychologists:
• Support
funding of research related to human trafficking.
• Advocate
for the development and implementation of
evidence-based, developmentally appropriate, culturally
appropriate, and trauma-informed services for survivors of
human trafficking.
Promote the integration of behavioral health services in settings
where trafficking survivors reside and receive services, including
schools, victim services, communities, foster and residential
care, juvenile justice, criminal justice, and health care.
• Promote
and inform the education and training of health,
healthy, noncoercive relationships; (d) helping youths distin-
educational, law enforcement, legal, child welfare, and social
guish between legitimate job opportunities and fraudulent
service professionals on the causes, signs, and consequences
66
of human trafficking, including mental health aspects, to
adults who have suffered from or are vulnerable to human
ensure that individuals are appropriately identified as at risk
trafficking, as consistent with the recommendations of the
for or as survivors of trafficking.
APA Presidential Task Force on Immigration (2012).
Identified individuals should be offered appropriate resources,
services, and support to ensure safety and optimal medical and
mental health outcomes.
• Support
evidence-based policies and programs to meet the
Recommendations
needs of girls as the fastest growing segment of the juvenile
justice system.
Address the substantial overlap between involvement in the
justice system and in human trafficking. For example, support
investments in competitive grant programs to help states and
localities better address the needs of girls in the juvenile and
criminal justice systems and to provide specific, targeted support for state efforts to implement best practices for at-risk and
system-involved girls.
• Advocate
addressing human trafficking in legislation and federal and state initiatives relating to runaway and homeless
youth, child welfare services, and foster care and adoption
assistance programs.
inclusion of information about sex-trafficking prac• Advocate
tices and prevention, intimate partner violence prevention,
sexualization, objectification, and healthy relationships in
school health and related programs, including comprehensive
sex education and other sexuality education programs.
policy that recognizes trafficked persons coerced
• Support
into illegal activities (e.g., prostitution) as victims rather
than criminals.
the development and utilization of empirically
• Promote
supported curriculum models and media literacy programs,
• Continue
to raise awareness of the behavioral health effects
of detention and deportation processes on immigrant
trafficking survivors and their families (adapted from the
recommendations of the APA Presidential Task Force on
Immigration, 2012).
• Promote
immigration policies that support trauma-informed,
developmentally appropriate, and culturally responsive behavioral health services and that recognize the importance of
family reunification in immigration proceedings when appropriate and in the best interest of the trafficking survivor, as
consistent with the APA Resolution on Immigrant Children,
Youth, and Families (1998) (adapted from the recommendations of the APA Task Force on Immigration, 2012).
• Advocate
review of immigration policy, including examination
of the temporary work visas and guest-worker programs, to
eliminate abusive labor conditions.
• Promote
protection of human rights for all workers in the
United States through support for humane and just labor
standards, enforcement of labor laws, and protection of
workers’ interests.
the impact of the current economic climate and
• Examine
policy on the well-being of the workforce.
• Advocate
careful examination of the connection between
free-trade policies and trafficking of persons into the United
States and to produce goods for U.S. consumption.
• Promote
policies that will provide access to lifelong health
including interactive media to prevent trafficking and
and mental health care to address the long-term and chronic
potentially counteract the effect of sexualization and objec-
health issues faced by survivors of trafficking.
tification of girls.
Interventions should be evaluated for effectiveness and potential
wide-scale adoption and should assess the impact of sexualization on girls and boys and consider important factors such as
race or ethnicity, sexual orientation, religious affiliation, disability
status, and socioeconomic status, consistent with the recommendations of the Report of the APA Task Force on the Sexualization
of Girls (APA, Task Force on the Sexualization of Girls, 2010).
• Advocate
for effective behavioral health and educational
supports for immigrant-origin children, adolescents, and
67
Public Awareness
Recommendations
To raise awareness of trafficking, the task force recommends that
public awareness campaigns be used to:
• Address
common misperceptions and myths about trafficking victims.
• Increase
awareness that human trafficking occurs within the
United States in all types of communities.
As such, awareness campaigns must be adapted for use in
diverse and multicultural communities.
• Increase
awareness of both labor and sex trafficking.
• Educate
the public about common signs of human trafficking
to help identify potential victims in their communities.
Report of the Task
Psychologists can be especially helpful in educating about signs
Force on Trafficking
of psychological coercion––often subtle and difficult to iden-
of Women and Girls
tify––in trafficking (e.g., grooming, traumatic bonding).
• Emphasize
prevention for parents and youth.
• Include
multilevel training created by long-term survivors
who are advanced in their own healing and have the necessary experience, professional skills, and training to work with
economically and culturally diverse stakeholders.
• Respect
the varied lived experiences of human
trafficking survivors.
Ensure that images are neither exploitive nor sensationalist in
nature to prevent stereotypical images of human trafficking
survivors. When public awareness programs include survivors as
speakers, the organizers and other speakers should be mindful of
avoiding unintentionally presenting survivors as “token” examples, or worse, “specimens” to be examined.
It is also recommended that:
• Public
service announcements provide survivor hotline numbers in addition to the Human Trafficking Resource Center
hotline number.
Institutions that may serve trafficked persons or may be locations of trafficking should post public service announcements
with hotline numbers.
• Public
awareness curricula address intersections and overlaps with other forms of violence (e.g., child abuse, intimate
partner violence), exploitation (e.g., labor exploitation and
violations), and vulnerable communities (e.g., immigrants,
refugee/asylees, homeless youth).
68
NOTES
Executive Summary
1. Within the TVPA, coercion is defined as “(a) threats of serious harm to or physical
4. The U.N. Protocol to Prevent, Suppress and Punish Trafficking in Persons, Especially
restraint against any person; (b) any scheme, plan or pattern intended to cause a per-
Women and Children is often referred to as “the Palermo Protocol” and was one of three
son to believe that failure to perform an act would result in serious harm to or physical
protocols that supplement the United Nations Convention against Transnational Organized
restraint against any person; or (c) the abuse or threatened abuse of the legal process”
Crime, Palermo, Italy, 2000.
and is distinguished from force, which involves actual physical violence or harm,
restraint or confinement (TVPA, 2000).
2. The U.N. Protocol to Prevent, Suppress and Punish Trafficking in Persons, Especially
Women and Children is often referred to as “the Palermo Protocol” and was one of three
protocols that supplement the United Nations Convention against Transnational Organized
Crime, Palermo, Italy, 2000.
3. Herman (1997) coined the term “complex PTSD” to describe a constellation of symptoms
that can include impaired cognitive functioning, emotional dysregulation, and distorted
perceptions of self, others, and perpetrators. Complex PTSD is a potential response when
individuals experience complex trauma on multiple occasions or on a chronic basis.
“Complex trauma” refers to severe harm that is interpersonal in nature. That is, such trauma
is purposefully inflicted through the actions of another person, through sexual abuse, relationship violence, exploitation, or similar violations (Courtois, 2008; Herman, 1997).
5. As of February 2013, all 50 states and the District of Columbia also had legislation criminalizing human trafficking (Polaris Project, 2013).
6. The FLC includes visas for foreign nationals to work in the United States on a permanent
(PERM) or temporary basis in agricultural (H-2A), technical/professional (H-1B), and
nonagricultural labor such as forestry (H-2B).
7. For additional case examples, see the human trafficking database at the University of
Michigan School of Law (http://www.law.umich.edu/clinical/HuTrafficCases/Pages/searchdatabase.aspx) and the UNODC case law database (https://www.unodc.org/cld/index.jspx).
8. Different conceptualizations of the levels are suggested by different authors. In this report
we use a slightly modified version of the model proposed by McLeroy et al. (1988).
9. The term human trafficking was used by the United Nations (1949) at least since the
mid-twentieth century, but no academic work using this terminology was located from
before the 1990s.
Introduction and Overview
1. Within the TVPA, coercion is defined as “(a) threats of serious harm to or physical
restraint against any person; (b) any scheme, plan or pattern intended to cause a person to believe that failure to perform an act would result in serious harm to or physical
restraint against any person; or (c) the abuse or threatened abuse of the legal process”
and is distinguished from force, which involves actual physical violence or harm,
restraint or confinement (TVPA, 2000).
10. For supplemental material, see http://www.apa.org/pi/women/programs/trafficking/
grids.pdf.
11. These two positions on prostitution roughly correspond to regulationist and abolitionist
positions (Council of Europe, 2007; Kullman, 2012). MacKinnon (2011) distinguished them
as the “sex work model” and the “sexual exploitation approach.” Although two diametrically opposed positions are presented here, this is not meant to imply that all scholars
adhere to one position or the other.
2. The task force originally defined its scope as women and girls trafficked into, within, and
from the United States. No empirical research was identified that dealt with trafficking
of women and girls out of the United States to other locations. However, anecdotal information and police reports of American Indian women and girls trafficked out of the United
Measuring Human Trafficking
1. Reid (2010) pointed out that child protective services do not always code sex trafficking
States through Duluth Harbor (Koepplinger, personal communication, March 22, 2008)
of a minor in a way that would identify it as human trafficking; it may be counted as
suggest this warrants further investigation.
child sexual abuse.
3. Trafficking that does not have a U.S. nexus and trafficking of men and boys are outside of
the task force charge.
2. Prostitution of minors falls within both the U.N. and U.S. definitions of trafficking. However,
the issue of commercial sex involving minors when no intermediary trafficker is involved
NOTES TO PAGES 21–48
in or profiting from the transaction (frequently called survival sex) is a grey area. Some
sources define survival sex as human trafficking; others do not.
3. Mitchell et al. (2010) separated racial data from data on Hispanic ethnicity, so categories
of White, Black, and “other” also contain individuals of Hispanic ethnicity. Kyckelhahn et al.
10. The term Aboriginal is used for two reasons. First, Canada’s Inuit and Métis peoples are
distinct from First Nations peoples. Second, government publications providing data on Native
peoples in Canada most often use the Aboriginal unless reporting on First Nations people alone.
11. See, for example, work by DeGruy-Leary (2005) and others on posttraumatic slave syndrome.
(2009) excluded persons of Hispanic ethnicity from their data on White and Black victims
and perpetrators.
Risk Factors for the Trafficking of Women and Girls
1. For the purposes of this report, we use globalization to encompass the increased interconnectedness among various entities worldwide (corporate, governmental, nongovernmental)
and policies that include free-trade agreements, increasing deregulation of corporate
Report of the Task
practices, and reduction of social programs such as education and health care in many
Force on Trafficking
nations. Globalization is characterized by (a) changing patterns of production of goods,
of Women and Girls
including outsourcing of jobs, free-trade zones with sweatshop industries, decreased power
of organized labor, and relative reductions in wages and benefits; (b) a relatively open flow
of capital and products between nations; (c) increasing demand for consumer goods not
Describing Human Trafficking
1. If the individual engaged in commercial sex is younger than 18, it is considered human
trafficking even in the absence of force, fraud, or coercion.
2. The nine nations were Thailand (56%, n = 166), Mexico (59%, n = 123), Germany (61%,
n = 54), South Africa (66%, n = 68), Colombia (70%, n = 96), Turkey (80%, n = 50), the
United States (82%, n = 130), Zambia (82%, n = 117), and Canada (91%, n = 100).
3. Farley et al. (2003) used three items to assess rape: “Have you been raped?” “Who raped
you?” “How many times have you been raped since you were in prostitution?”
4. For example, $ indicates $100; $$ indicates $200; “Jacks” or “Jacksons” indicate $20.
only in affluent nations but also in newly opened markets in Asia, Africa, Eastern Europe,
and South America; and (d) enhanced communication and technological connectedness
between peoples across the globe.
2. Foreign-born persons include “anyone who is not a U.S. citizen at birth. This includes naturalized
citizens, lawful permanent residents [LPRs], temporary migrants (such as foreign students),
humanitarian migrants (such as refugees), and undocumented migrants” (Grieco et al., 2012,
p. 3). Of these, 17.5 million were naturalized U.S. citizens and 22.5 million were noncitizens
(LPRs, temporary migrants, humanitarian migrants, and undocumented migrants).
3. According to the Southern Poverty Law Center (2013), “In 2011, the last year for which
data are available, the United States issued about 55,000 H-2A visas and about 51,000
H-2B visas.”
4. In cases of international trafficking, source countries and countries of origin refer to the
nations from which the trafficking originated; destination countries refers to the nations
in which the forced labor or CSE takes place; and transit countries refers to nations
through which trafficked persons may be transported to reach the destination country.
Some nations, including the United States, are source, transit, and destination countries
(U.S. Department of State, 2010).
5. Two recent cases illustrate the use of migrant smuggling operations to recruit victims in
Mexico and Central America and then traffic them into the sex trade and forced labor in
the United States. In May 2011, U.S. authorities arrested 19 members of the HernandezCastillo brothers’ network, which smuggled women from Mexico and Central America and
then trafficked them into prostitution at brothels in Indianapolis, Cincinnati, Chicago, and
Grand Rapids, MI (Kusmer, 2011). The same year, a federal jury convicted three New York
Consequences and Impact of Trafficking
1. For a list of the empirical studies used in this report, see http://www.apa.org/pi/
womenpprograms/trafficking/grids.pdf.
2. Important empirical research on this topic was conducted in the 1980s and early 1990s,
predating the current terminology of sex trafficking or CSEC.
3. A similar practice exists in refugee studies, where the findings from one cultural refugee
group are often generalized to inform interventions for other groups (Kaczorowski et al.,
2011).
4. Research findings indicate Stockholm syndrome is also common among sexually exploited
and battered women, incest victims, concentration camp prisoners (Graham, 1994), and
victims of child sexual abuse (Julich, 2005).
5. Social pain refers to the pain people experience as a result of social injury (e.g., ostracism,
bullying, marginalization) (Eisenberger & Lieberman, 2004).
6. “Prostitution is like rape. It’s like when I was 15 years old and I was raped. I used to
experience leaving my body. I mean that’s what I did when that man raped me. I went to
the ceiling and I numbed myself because I didn’t want to feel what I was feeling. I was
very frightened. And while I was a prostitute, I used to do that all the time. I would numb
my feelings. I wouldn’t even feel like I was in my body. I would actually leave my body and
go somewhere else with my thoughts and with my feelings until he got off and it was over
with. I don’t know how else to explain it except that it felt like rape. It was rape to me”
(Giobbe, 1991, p. 144).
men of collaborating to recruit and smuggle women from Honduras, Guatemala, Mexico,
and El Salvador into the United States, where they were forced to labor as waitresses and
to engage in prostitution (“Three Convicted of Sex Trafficking,” 2011). Asian gangs have
also been implicated in the trafficking of a considerable number of South Korean women
through Canada and into the United States (U.S. Department of State, 2011b).
6. Van Liemt defines the underground economy as comprising “those paid work activities
leading to the production of legal goods and services that are excluded from the protection
of laws and administrative rules covering commercial licensing, labour contracts, income
taxation, and social security systems” (2004, p. 11).
7. Traumatic bonding is defined by Dutton and Painter (1993) as “powerful emotional
Responding to Trafficking of Women and Girls
1. Both the United Nations and the U.S. government began with a “3 P” framework (prevention, protection, and prosecution) but added a fourth P: partnership (United Nations, 2008;
U.S. Department of State, 2011a).
2. Among programs employing survivor mentoring or survivor leadership to address CSE and
CSEC are Breaking Free (St. Paul, MN), Courtney’s House (Washington DC), Girls Education
and Mentoring Services (GEMS) (New York, NY), Mary Magdalene Project (Los Angeles, CA),
MISSSEY (Oakland, CA), My Life, My Choice Project (MLMC) (Boston, MA), PEERS (British
Columbia, Canada), SAGE Project (San Francisco, CA), and Veronica’s Voice (Kansas
attachments … [that] develop from two specific features of abusive relationships: power
City, MO). Empirical reports of program evaluation information were not available in the
imbalances and intermittent good–bad treatment” (p. 105).
peer-reviewed literature.
8. D. Banks and Kyckelhahn (2011) reported only whether cases were identified as sex
3. The California Evidence-Based Clearinghouse for Child Welfare (n.d.) posts information
trafficking or labor trafficking; it is not possible to determine from this report whether any
regarding existing programs for girls victimized by CSEC. However, there is not enough
of the cases combined elements of both.
information to provide ratings of evidence support (http://www.cebc4cw.org/topic/
9. Raphael and Ashley (2008) reported that family members were the exploiters for 10% of
their sample (n = 100). Gragg et al. (2007) reported 6–7% in their New York City sample
(n = 2,121), and 10–16% in their upstate New York sample (n = 399) were exploited by
family members. Kennedy and Pucci (2007) related that a service provider estimated that
up to 30% of the commercially exploited youths they served had been exploited by a family
member. Pierce (2009), O’Leary and Howard (2001), and Priebe and Suhr (2005) reported
that some of their sample was exploited by family members, but frequencies or percentages
were not given.
70
commercial-sexual-exploitation-of-children-and-adolescents-services-for-victims/).
4. Metropolitan State University of Denver offers one such program.
5. This technique is called a “reverse sting” or “john sting” to differentiate it from stings in
which the individual involved in commercial sex is targeted for arrest.
6. So named because it was instituted nationwide in Sweden in 1999.
NOTES TO PAGES 49–61
7. Child labor may be involved in products imported to the United States or may take place
realities of the sex trade, “pimp’s rules,” what a healthy relationship actually looks like,
v. Broadway Plaza Hotel, 2005; United States v. Abdenasser Ennassime, 2006; United
and their human rights. Program goals are to (a) reduce the likelihood that youths will
States v. Abdel Nasser Youssef Ibrahim, 2006; USA v. Mariluz Zavala and Jose Ibanez,
be exploited because of peer/community risks and (b) give youths who are already CSEC
2004; and United States v. Akouavi Kpade Afolabi, 2009.
victims, but who do not identify as such, support and time to consider that the situation
8. “Continued Presence (CP) is a temporary immigration status provided to individuals
identified by law enforcement as victims of human trafficking. This status allows victims
of human trafficking to remain in the U.S. temporarily during the ongoing investigation
Notes
where youths can be safe, interact with peers in group activities, and learn about the
on U.S. soil. Examples of child labor within the United States include Juana Sierra Trejo
they are in is exploitative and harmful and that help is available for them if and when they
are ready.
11. The Minneapolis Indian Women’s Resource Center offers one such program that is
into the human trafficking-related crimes committed against them. CP is initially granted
described more fully in the section on empowerment programs (see p. 47). Proponents of
for one year and may be renewed in one-year increments” (U.S. Immigration and Customs
these programs consider their harm reduction approach to be more “upstream” (primary
Enforcement, 2010, p. 2).
and secondary prevention) than traditional harm reduction models.
9. Structural violence—as opposed to interpersonal violence—refers to the harm inflicted by 12. The Polaris Project (2011a) provides examples of screening questions such as “Did
social systems and structures, including oppression, discrimination, and poverty.
anyone ever force you to engage in sexual acts with friends or business associates for
favors/money?”
The Role of the Psychologist
1. Community-based participatory research (CBPR) is “a partnership approach to research
that equitably involves, for example, community members, organizational representatives,
and researchers in all aspects of the research process” (Israel et al., 2003). For examples
of CBPR used with human trafficking issues, see Laboratory to Combat Human Trafficking
(2012) and Pierce (2009, 2012).
2. For example, Psychology of Violence and Aggression, Psychology of Women, Psychology and
the Law, and Industrial/Organizational Psychology.
3. For example, at Metropolitan State University of Denver: Women’s Studies 4160–Human
Trafficking, a cross-listed course with African/African American Studies, Criminal Justice
and Criminology, Human Services, Psychology, Social Work, and Honors.
4. The Victims of Violence Program (VOV), located in Cambridge, MA, is an adult, outpatient
13. The U.S. Department of Health and Human Services’ Rescue & Restore Campaign
provides free training materials for health care, social service, and law enforcement
personnel online or by mail. Go to http://www.acf.hhs.gov/programs/orr/resource/
rescue-restore-campaign-tool-kits.
14. The T-visa provides immigration relief to victims of human trafficking who have been
certified by federal authorities and have met specific criteria outlined in the TVPA.
The visa provides access to benefits that would otherwise be unavailable due to
undocumented status.
15. Pertinent sections in the APA Ethics Code (2002, 2010a) include:
Principle A: Beneficence and Nonmaleficence: Psychologists strive to benefit those with
whom they work and take care to do no harm. … Psychologists strive to be aware of the
possible effect of their own physical and mental health on their ability to help those with
trauma clinic. The VOV clinic was established in 1984 and became a clinical training pro-
whom they work.
gram of Harvard Medical School in 1985. Currently, VOV is a training program for graduate
2.03 Maintaining Competence: Psychologists undertake ongoing efforts to develop and
and postgraduate clinical trainees. Additionally, the clinic provides clinical resources for
victims, is a setting for community and clinical research, provides consultation and training resources nationally and internationally, and contributes to global anti-violence efforts.
maintain their competence.
2.06 Personal Problems and Conflicts: (a) Psychologists refrain from initiating an activity when they know or should know that there is a substantial likelihood that their personal
5. For example, see http://www.apa.org/ed/sponsor/resources/requirements.aspx.
problems will prevent them from performing their work-related activities in a competent
6. For example, psychologists could advocate with school boards for programming for youth
manner. (b) When psychologists become aware of personal problems that may interfere with
regarding healthy relationships and prevention of interpersonal violence and training for
school personnel. Others might engage with state legislators and state agencies’ administrators to examine the role child-protection system policies could play in early identification of and intervention with youths at risk for trafficking. Other psychologists might
their performing work-related duties adequately, they take appropriate measures, such as
obtaining professional consultation or assistance and determine whether they should limit,
suspend or terminate their work-related duties.
16. Such strategies will vary depending on individual needs and preferences but may include
inform legislators about the human costs of temporary visa programs that can expose
expressive activities (art, music, writing, dance), athletics (team sports, running, martial
domestic servants and migrant laborers to significant abuse at the hands of employers.
arts, cycling, swimming), meditation, massage, spending time in nature (hiking, fishing,
7. For example, the comprehensive delivery of services for human trafficking survivors
would include mental health, substance use, housing, vocational or employment support,
domestic violence and victim assistance, and peer support. A comprehensive approach
would include specialized neuropsychological assessment, including assessment for head
trauma and traumatic brain injury. A refugee/asylee report should also be elicited.
8. Programs such as Project REACH in Massachusetts that operates out of the Trauma
Center at the Justice Resource Institute have been responding to some of these needs by
providing nationwide multidisciplinary consultation on trauma and human trafficking. In
Project REACH program evaluation reports, providers describe these consultation services
as extremely helpful in understanding traumatic stress in victims, in developing trauma-informed services, and in helping clients understand their own reactions and begin to
develop coping skills (Coquillon, 2011).
9. Proponents of harm reduction argue that certain behaviors (e.g., illicit drug use, adolescent sexual behavior, prostitution) will always occur and the responsible approach is to
“work
to minimize [their] harmful effects rather than simply ignore or condemn them”
(Harm Reduction Coalition, n.d.). Rather than prevent the activity itself, the goal is to
reduce harmful impacts by providing services without judgment of the underlying activity
(drug use, commercial sex) to create an atmosphere in which services can be sought
without fear of pressuring, shaming, or coercing clients who are not ready or able to
change their behavior.
10. They give youths the opportunity to identify what they consider to be their most urgent
needs and then help them meet those needs. The core component is providing a space
71
camping), or spending quality time with intimate friends or family.
REFERENCES
Abt Associates. (n.d.). John school. Retrieved from http://www.demandforum.net/
john-school
Acharya, A. K. (2008). Sexual violence and proximate risks: A study on trafficked women in
Mexico City. Gender, Technology and Development, 12, 77-99.
Acharya, A. K., & Clark, J. B. (2010). The health consequences of trafficking in women in
Mexico: Findings from Monterrey city. International Review of Sociology, 20(3),
415-426.
Adams, E. J. (2010). Healing invisible wounds: Why investing in trauma-informed care
for children makes sense. Washington DC: Justice Policy Institute. Retrieved from
http://www.justicepolicy.org/images/upload/10-07_REP_HealingInvisibleWounds_
JJ-PS.pdf
Adams, R. E., Boscarino, J. A., & Figley, C. R. (2006). Compassion fatigue and
American Psychological Association. (2002). Ethical principles of psychologists and code
of conduct. American Psychologist, 57, 1060–1073.
American Psychological Association. (2008). Report of the Task Force on the
Implementation of the Multicultural Guidelines. Retrieved from http://www.apa.
org/about/policy/multicultural-report.pdf
American Psychological Association. (2010a). 2010 Amendments to the 2002 ethical
principles of psychologists and code of conduct. Retrieved from http://www.apa.
org/ethics/code/principles.pdf
American Psychological Association. (2010b). A psychologist’s guide to federal advocacy:
Advancing psychology in the public interest. Washington, DC: American
Psychological Association, Public Interest Government Relations Office.
American Psychological Association, Division 35, Special Committee on Violence Against
psychological distress among social workers: A validation study. American Journal
Women. (n.d.). Report on trafficking of women and girls. Retrieved from http://
of Orthopsychiatry, 76(1), 103-108.
www.apadivisions.org/ division-35/leadership/task-forces/trafficking/women-
Adelson, W. J. (2008). Child prostitute or victim of trafficking? University of St. Thomas
Law Journal, 6, 96-128.
Albanese, J. (2007). Commercial sexual exploitation of children: What do we know and
what do we do about it? Washington, DC: U.S. Department of Justice, Office of
Justice Programs. Retrieved from http://www.ncjrs.gov/pdffiles1/nij/215733.pdf
Alegría, M., Vera, M., Freeman, D. H., Robles, R., Santos, M.C., & Rivera, C. L. (1994).
HIV infection, risk behaviors, and depressive symptoms among Puerto Rican sex
workers. American Journal of Public Health, 84, 2000-2002.
Alejano-Steele, A. (2011, August). Localizing human trafficking in Colorado: Intersections
with domestic violence and other forms of interpersonal violence. Paper presented
at the Human Trafficking: Crossroads of Control Conference, Denver, CO.
Alexander, M. P., Kellogg, N. D., & Thompson, P. (2005). Community and mental health
support of juvenile victims of prostitution. In S. W. Cooper, R. J. Estes, A. P.
Giardino, N. D. Kellogg, & V. I. Vieth (Eds.), Medical, legal and social science
aspects of child sexual exploitation (Vol. 1, pp. 397-421). St. Louis, MO: G. W.
Medical Publishing.
American Civil Liberties Union. (2007). Modern enslavement of migrant domestic workers
by foreign diplomats in the United States. Retrieved from http://www.aclu.org/
human-rights-immigrants-rights-womens-rights/domestic-workers
American Psychiatric Association. (1980). Diagnostic and statistical manual of mental
disorders (3rd ed.). Washington, DC: Author.
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental
disorders (5th ed.). Arlington, VA: Author.
girls-report.aspx?item=3
American Psychological Association, Presidential Task Force on Immigration. (2012).
Crossroads: The psychology of immigration in the new century. Retrieved from
http://www.apa.org/topics/immigration/report.aspx
American Psychological Association, Task Force on the Sexualization of Girls. (2010).
Report of the APA Task Force on the Sexualization of Girls. Retrieved from http://
www.apa.org/pi/women/programs/girls/report.aspx
American University Washington College of Law International Human Rights Law Clinic &
Centro de los Derechos del Migrante. (2010). Picked apart: The hidden struggles of
migrant worker women in the Maryland crab industry. Retrieved from http://www.
wcl.american.edu/clinical/documents/20100714_auwcl_ihrlc_picked_apart.pdf
Andolina Scott, K. (2008). Domestic minor sex trafficking assessment report, Buffalo NY.
Retrieved from the Shared Hope International website: http://www.sharedhope.org/
Portals/0/Documents/Buffalo_PrinterFriendly.pdf
Annie E. Casey Foundation, KIDS COUNT Data Center. (2013). Children in poverty (percent)
– 2011. Retrieved from http://datacenter.kidscount.org/data/tables/
43-children-in-poverty-100-percent-poverty?loc=1&loct=2#ranking/3/any/
true/867/any/322
Arcury, T. A., & Quandt, S. A. (2007). Delivery of health services to migrant and seasonal
farmworkers. Annual Review of Public Health, 28, 345-363.
Arizona State University. (2012, November 29). Human trafficking activity on adult
entertainment website more pervasive than expected [Press release]. Phoenix,
AZ: Author.
Aron, L. Y., Zweig, J. M., & Newmark, L. C. (2006). Comprehensive services for survivors of
Reauthorization Act of 2008, with explanatory statement. Congressional Record
Urban Institute, Justice Policy Center.
154(185), H10888-H10904. Retrieved from http://www.gpo.gov/fdsys/pkg/CREC-
Aronowitz, A. (2004). Victimization of trafficked persons and illegal migrants.
Beyrer, C. (2004). Is trafficking a health issue? The Lancet, 363, 564-564.
sagepub.com/content/11/1/11.full.pdf+html
Blevins, K. R., & Holt, T. J. (2009). Examining the virtual subculture of johns. Journal of
beings. Westport, CT: Praeger. Retrieved from http://is.cuni.cz/studium/predmety/
index.php?do=download&did=33454&kod=JPM346
Bagley, C., & Young, L. (1987). Juvenile prostitution and child sexual abuse: A controlled
study. Canadian Journal of Community Mental Health, 6(1), 5-26.
Baker, E. K. (2003). Caring for ourselves as psychologists. Washington, DC: National
Register of Health Service Psychologists. Retrieved from http://www.epsychologist.org/index.iml?mdl=exam/show_article.mdl&Material_ID=1
Force on Trafficking
of Women and Girls
Baker, L. M., Dalla, R. L., & Williamson, C. (2010). Exiting prostitution: An integrated
model. Violence Against Women, 16, 579-600.
Bales, K. (1999). Disposable people: New slavery in the global economy. Berkeley, CA:
University of California Press.
Bales, K. (2003, July). Understanding the demand behind human trafficking.
Paper presented at the National Institute of Justice, Washington
DC. Retrieved from http://lastradainternational.org/lsidocs/520%20
bales__understanding_the_de.pdf
Bales, K. (2004). Slavery and the human right to evil. Journal of Human Rights, 3, 53-63.
Bales, K., & Soodalter, R. (2009). The slave next door: Human trafficking and slavery in
America today. Berkeley, CA: University of California Press.
Banks, A. (2006). Relational therapy for trauma. Journal of Trauma Practice, 5, 25-47.
Banks, A. (2011). Developing the capacity to connect. Zygon, 46, 168-182.
Banks, D., & Kyckelhahn, T. (2011). Characteristics of suspected human trafficking
incidents, 2008-2010. Retrieved from the U.S. Department of Justice website:
http://bjs.ojp.usdoj.gov/content/pub/pdf/cshti0810.pdf
Barnett, J. E. (2008). Psychological wellness and self-care as an ethical imperative.
Retrieved from http://www.apa.org/careers/early-career/psychological-wellness.pdf
Barnett, J. E., & Cooper, N. (2009). Creating a culture of self-care. Clinical Psychology:
Science and Practice, 16, 16-20.
Barnitz, L. A. (2000). Commercial sexual exploitation of children: Youth involved in
prostitution, pornography, & sex trafficking. Washington DC: Youth Advocate
Contemporary Ethnography, 38, 619-648.
Bokhari, F. (2008). Falling through the gaps: Safeguarding children trafficked into the UK.
Children and Society, 22, 201-211. doi:10.1111/j.1099-0860.2008.00151.x
Boland, F., & Durwyn, M. (1999). Fetal alcohol syndrome: Understanding its impact.
Retrieved from the Correctional Service of Canada website: http://www.csc-scc.
gc.ca/text/pblct/forum/e121/121e_e.pdf
Bosworth, M., Hoyle, C., & Dempsey, M. M. (2011). Researching trafficked women: On
institutional resistance and the limits to feminist reflexivity. Qualitative Inquiry,
17, 769-779.
Boxill, N., & Richardson, D. (2005). A community’s response to the sex trafficking
of children. The Link, Child Welfare League of America. Retrieved from
http://66.227.70.18/programs/juvenilejustice/thelink2005winter.pdf
Boxill, N. A., & Richardson, D. J. (2007). Ending sex trafficking of children in Atlanta.
Affilia Journal of Women and Social Work, 22, 138-150.
Boyer, D. (2008). Who pays the price? Assessment of youth involvement in prostitution
in Seattle. Seattle, WA: City of Seattle Human Services Department, Domestic
Violence & Sexual Assault Prevention Division.
Brannigan, A., & Van Brunschot, E. G. (1997). Youthful prostitution and child sexual
trauma. International Journal of Law and Psychiatry, 20, 337–354.
Brave Heart, M. Y. H. (2003). The historical trauma response among Natives and its
relationship with substance abuse: A Lakota illustration. Journal of Psychoactive
Drugs, 35, 7-13.
Brave Heart, M. Y. H., & DeBruyn, L. M. (1998). The American Indian Holocaust: Healing
historical unresolved grief. American Indian and Alaska Native Mental Health
Research, 8(2), 60-82. doi:10.5820/aian.0802.1998.60
Brennan, D. (2002). Selling sex for visas: Sex tourism as a stepping-stone to international
migration. In B. Ehrenreich & A. R. Hochschild (Eds.), Global woman: Nannies,
maids, and sex workers in the new economy (pp. 154-168). New York, NY:
Metropolitan Books.
Brennan, D. (2005). Methodological challenges in research with trafficked persons: Tales
Program International. Retrieved from http://www.yapi.org/old/publications/
from the field. In F. Laczko & E. Gozdziak (Eds.), Data and research on human
bookletseries/cse.pdf
trafficking: A global survey (pp. 35-54). Geneva, Switzerland: International
Barnitz, L. (2001). Effectively responding to the commercial sexual exploitation of children:
A comprehensive approach to prevention, protection and reintegration services.
Child Welfare, 53(5), 597-611.
Barrett, N., & Shaw, M. (2011). Towards human trafficking prevention: A discussion
document. Vancouver, British Columbia, Canada: International Centre for
Organization on Migration. Retrieved from http://www.iom.int/jahia/webdav/site/
myjahiasite/shared/shared/mainsite/published_docs/books/data_res_human.pdf
Brennan, D. (2008). Competing claims of victimhood? Foreign and domestic victims of
trafficking in the United States. Sexuality Research and Social Policy, 5(4), 45-61.
Brown, J. D., Hotchkiss, J. L., & Quispe-Agnoli, M. (2008, December). Undocumented worker
Criminal Law Reform and Criminal Justice Policy. Retrieved from http://www.
employment and firm survivability (Working Paper 2008-28). Retrieved from the
crime-prevention-intl.org/fileadmin/user_ upload/Publications/Towards_Human_
Federal Reserve Bank of Atlanta website: http://www.frbatlanta.org/filelegacydocs/
Trafficking_Prevention_A_Discussion_Document_-_May_27.pdf
Barrows, J., & Finger, R. (2008). Human trafficking and the healthcare professional.
Southern Medical Journal, 101(5), 521-524.
Barry, K. (1979). Female sexual slavery. Englewood Cliffs, NJ: Prentice Hall.
Batstone, D. (2007). Not for sale: The return of the global slave trade – and how we can
fight it. New York, NY: HarperCollins.
Bauer, M. (2007). Close to slavery: Guestworker programs in the United States.
Montgomery, AL: Southern Poverty Law Center. Retrieved from www.splcenter.org
Bauer, M., & Ramírez, M. (2010). Injustice on our plates: Immigrant women in the U.S. food
industry. Montgomery, AL: Southern Poverty Law Center. Retrieved from http://cdna.
splcenter.org/sites/default/files/downloads/publication/Injustice_on_Our_Plates.
pdf
Bayou Lawn & Landscape Services, et al. v. Hilda Solis, et al. (2012, April). Court order
granting preliminary injunction. Case No: 3:12cv183/MCR/CJK. Retrieved from
http://tinyurl.com/nkwlxuv
Bemak, F., Chung, R. C.-Y., & Pederson, P. B. (2003). Counseling refugees: A psychosocial
approach to innovative multicultural interventions. Westport, CT: Greenwood.
Bensimon, N. (2012). Elaboration on the association between trauma, PTSD and
posttraumatic growth: The role of trait resilience. Personality and Individual
Differences, 52, 782-787.
74
2008-12-10/pdf/CREC-2008-12-10.pdf
International Review of Victimology 11(1), 11-32. Retrieved from http://irv.
Aronowitz, A. A. (2009). Human trafficking, human misery: The global trade in human
Report of the Task
Berman, H. (2008, December 10). William Wilberforce Trafficking Victims Protection
human trafficking: Findings from clients in three communities. Washington, DC:
wp0828.pdf
Bruckert, C., & Parent, C. (2002). Trafficking in human beings and organized crime: A
literature review. Ottawa, ON: Royal Canadian Mounted Police. Retrieved from
http://www.rcmp-grc.gc.ca/pubs/ccaps-spcca/traffick-eng.htm
Brunovskis, A., & Surtees, R. (2007). Leaving the past behind? When victims of trafficking
decline assistance. Oslo, Norway: Fafo. Retrieved from http://www.fafo.no/pub/
rapp/20040/20040.pdf
Bruskas, D. (2008). Children in foster care: A vulnerable population at risk. Journal of
Child and Adolescent Psychiatric Nursing, 21(2), 70-77.
Bryant-Davis, T. (2005). Coping strategies of African American adult survivors of
childhood violence. Professional Psychology: Research and Practice, 36, 409-414.
Bureau of Labor Statistics. (2013, March). Economic news release: Civilian labor force
and unemployment by state and metropolitan areas. Retrieved from http://bls.gov/
news.release/metro.t01.htm
Burnette, M. L., Lucas, E., Ilgen, M., Frayne, S. M., Mayo, J., & Weitlauf, J. C. (2008).
Prevalence and health correlates of prostitution among patients entering
treatment for substance use disorders. Archives of General Psychiatry, 65,
337-344.
Busch-Armendariz, N. B. (2012). T visas. In S. Loue & M. Sajatovic (Eds.), The
encyclopedia of immigrant health. New York, NY: Springer.
Busch-Armendariz, N. B., Nsonwu, M., & Heffron, L. C. (2011). Human trafficking victims
trafficking: Challenges, barriers, and promising practices. Washington, DC: U.S.
Journal of Applied Research on Children: Informing Policy for Children at Risk,
Department of Health and Human Services, Office of the Assistant Secretary for
2(1), 1-19.
Business Transparency on Trafficking and Slavery Act, H.R. 2759, 112th Cong. (2011).
Butcher, K. (2003). Confusion between prostitution and sex trafficking. The Lancet, 361,
1983.
Caldwell, G., Galster, S., Kanics, J., & Steinzor, N. (1999). Capitalizing on transition
economies: The role of the Russian mafia in trafficking women for forced
Planning and Evaluation.
Clawson, H. J., Dutch, N., & Cummings, M. (2006). Law enforcement response to human
trafficking and implications for victims: Current practices and lessons learned
(Final report submitted to U.S. Department of Justice). Fairfax, VA: Caliber.
Retrieved from https://www.ncjrs.gov/pdffiles1/nij/grants/216547.pdf
Clawson, H. J., Dutch, N., Salomon, A., & Goldblatt Grace, L. (2009). Human trafficking
prostitution. In P. Williams (Ed.), Illegal immigration and commercial sex: The new
into and within the United States: A review of the literature. Washington, DC:
slave trade (pp. 42-73). London, England: Frank Cass.
Department of Health and Human Services. Retrieved from http://aspe.hhs.gov/
Caliber. (2007). Evaluation of comprehensive services for victims of human trafficking:
Key findings and lessons learned. Fairfax, VA: Author. Retrieved from https://www.
References
Clawson, H. J., & Dutch, N. M. (2008). Addressing the needs of victims of human
and their children: Assessing needs, vulnerabilities, strengths, and survivorship.
ncjrs.gov/pdffiles1/nij/grants/218777.pdf
California Evidence-Based Clearinghouse for Child Welfare. (n.d. Commercial sexual
exploitation of children and adolescents: Services for victims. Retrieved from
http://www.cebc4cw.org/topic/commercial-sexual-exploitation-of-children-andadolescents-services-for-victims/
California Transparency in Supply Chains Act. (2010). Cal. Stat. 556 §§ 1714.43 &
19547.5. Retrieved from http://www.leginfo.ca.gov/cgi-bin/statquery
Cantor, C., & Price, J. (2007). Traumatic entrapment, appeasement and complex
post-traumatic stress disorder: Evolutionary perspectives of hostage reactions,
domestic abuse and the Stockholm Syndrome. Australian and New Zealand Journal
of Psychiatry, 41, 377-384.
Carroll, L., Gilroy, P. J., & Murra, J. (1999). The moral imperative: Self-care for women
psychotherapists. Women & Therapy, 22, 133-143.
Castle, T., & Lee, J. (2008). Ordering sex in cyberspace: A content analysis of escort
websites. International Journal of Cultural Studies, 11, 107-121.
CdeBaca, L. (2010). Best practices: Human trafficking in disaster zones. Retrieved from
http://www.state.gov/j/tip/rls/rm/2010/142160.htm
Cecchet, S. J. (2012). The psychological experience of child and adolescent sex trafficking
in the United States: Trauma and resilience in survivors. UMI Dissertations
Publishing. (UMI No. 3505094).
Chacon, J. (2006). Misery and myopia: Understanding the failures of U.S. efforts to stop
human trafficking. Fordham Law Review, 74, 2977-3040.
Chanowitz, B., & Langer, E. (1981). Premature cognitive commitment. Journal of
Personality and Social Psychology, 41, 1051–1063.
Chicago Alliance Against Sexual Exploitation (CAASE). (n.d.). Empowering young men to
end sexual exploitation: A four session curriculum. Retrieved from http://g.virbcdn.
com/_f/files/70/FileItem-148531-Curriculumdescription.pdf
Choi, H., Klein, C., Shin M-S., & Lee, H-J. (2009). Posttraumatic stress disorder (PTSD)
and disorders of extreme stress (DESNOS) symptoms following prostitution and
childhood abuse. Violence Against Women, 15, 933-951.
Chuang, J. (1998). Redirecting the debate over trafficking in women: Definitions,
paradigms, and contexts. Harvard Human Rights Journal, 11, 65-107.
Chuang, J. (2006). Beyond a snapshot: Preventing human trafficking in the global
economy. Indiana Journal of Global Legal Studies, 13, 137-163.
Chuang, J. A. (2010). Achieving accountability for migrant domestic worker abuse. North
Caroline Law Review, 88, 1628-1656.
Chudakov, B., Ilan, K., Belmaker, R. H., & Cwikel, J. (2002). The motivation and mental
health of sex workers.Journal of Sex & Marital Therapy, 28, 305–315.
hsp/07/humantrafficking/litrev/
Clawson, H. J., Dutch, N. M., & Williamson, E. (2008). National symposium on the health
needs of human trafficking victims: Background brief. Washington, DC: U.S.
Department of Health and Human Services, Office of the Assistant Secretary for
Planning and Evaluation.
Clawson, H. J., Layne, M., & Small, K. (2006). Estimating human trafficking into the United
States: Development of a methodology. Fairfax, VA: Caliber. Retrieved from https://
www.ncjrs.gov/pdffiles1/nij/grants/215475.pdf
Clawson, H. J., Salomon, A., & Goldblatt Grace, L. (2008). Treating the hidden wounds:
Trauma treatment and mental health recovery for victims of human trafficking.
Washington, DC: U.S. Department of Health and Human Services.
Clawson, H. J., Small, K. M., Go, E. S., & Myles, B. W. (2003). Needs assessment for service
providers and trafficking victims. Fairfax, VA: Caliber. Retrieved from https://www.
ncjrs.gov/pdffiles1/nij/grants/202469.pdf
Cloitre, M., Courtois, C. A., Charuvastra, A., Carapezza, R., Stolbach, B. C., & Green, B. L.
(2011). Treatment of complex PTSD: Results of the ISTSS expert clinician survey on
best practices. Journal of Traumatic Stress, 24, 615-627.
Coalition of Immokalee Workers. (2012). Slavery in the fields and the food
we eat. Retrieved from http://www.ciw-online.org/Resources/tools/
general/12SlaveryintheFields.pdf
Cole, P., & Putnam, F. W. (1992). Effect of incest on self and social functioning: A
developmental psychopathology perspective. Journal of Consulting and Clinical
Psychology, 60, 174­1 84. doi:10.1037/0022-006X.60.2.174
Committee of Inquiry to Evaluate the Ban against the Purchase of Sexual Services.
(2010). Selected extracts of the Swedish government report SOU 2010:49: The
ban against the purchase of sexual services. An evaluation 1999-2008 (M. L.
Key & J. Evans, Trans.). Retrieved from http://www.sweden.gov.se/content/1/
c6/15/14/88/0e51eb7f.pdf
Cook, A., Spinazzola, J., Ford, J., Lanktree, C., Blaustein, M., Cloitre, M. … van der Kolk,
B. (2005). Complex trauma in children and adolescents. Psychiatric Annals, 35,
391-398.
Coomaraswamy, R. (2000, February). Integration of the human rights of women and the
gender perspective: Violence against women (Report of the Special Rapporteur on
Violence Against Women). Retrieved from http://www.globaldetentionproject.org/
fileadmin/docs/Special-Rapporteur-on-Violence-against-Women-its-Causes-andConsequences-Radhika-Coomaraswamy-2000.pdf
Coonan, T. (2004). Human trafficking: Victims’ voices in Florida. Journal of Social Work
Research and Evaluation, 5(2), 207-216.
Coquillon, E. (2011). Project REACH Program Evaluation Report 2011. Unpublished
manuscript.
Chung, R. (2005). Women, human rights, and counseling: Crossing international
Council of Europe. (2007). Resolution 1579. Prostitution – Which stance to take? Retrieved
boundaries. Journal of Counseling & Development, 83, 262-268.
from http://assembly.coe.int/main.asp?Link=/documents/adoptedtext/ta07/
Chung, R. (2009). Cultural perspectives on child trafficking, human rights & social
justice: A model for psychologists. Counseling Psychology Quarterly,22, 85-96.
doi:10.1080/09515070902761230
Chung, R. C-Y., Bemak, F., Ortiz, D. P., & Sandoval-Perez, P. A. (2008). Promoting the
mental health of immigrants: A multicultural/social justice perspective. Journal of
Counseling & Development, 86, 310-318.
Clatts, M. C., Davis, W. R., Sotheran, J. L., & Atillasoy, A. (1998). Correlates and
distribution of HIV risk behaviors among homeless youth in New York City:
Implications for prevention services and policies. Child Welfare, 37, 195-207.
Claude, K. (2010). Targeting the sex buyer. The Swedish example: Stopping prostitution
and trafficking where it all begins. Solna, Sweden: The Swedish Institute.
75
eres1579.htm
Courtois, C. A. (2004). Complex trauma, complex reactions: Assessment and treatment.
Psychotherapy: Theory, Research, Practice, Training, 41, 412-425.
Courtois, C. A. (2008). Complex trauma, complex reactions: Assessment and treatment.
Psychological Trauma: Theory, Research, Practice and Policy, 8, 86-100.
doi:10.1037/1942-9681.S.1.86
Coy, M. (2008). Young women, local authority, care and selling sex. British Journal of
Social Work, 38(7), 1408-1424.
Crawford, M., & Kaufman, M. R. (2008). Sex trafficking in Nepal: Survivor characteristics
and long-term outcomes. Violence Against Women, 14, 905-916.
Cunningham, S., & Kendall, T. (2011). Men in transit and prostitution: Using political
Retrieved from http://www.si.se/upload/Human%20Trafficking/Targeting%20
conventions as a natural experiment. The B.E. Journal of Economic Analysis &
the%20sex%20buyer.pdf
Policy, 11, 1-18.
Curl, C. L., Fenske, R. A., Kissel, J. C., Shirai, J. H., Moate, T. F., Griffith, W., … Thompson,
B. (2002). Evaluation of take-home organophosphorus pesticide exposure among
agricultural workers and their children. Environmental Health Perspectives, 110,
A787-792.
Curtis, R., Terry, K., Dank, M., Dombrowski, K., & Khan, B. (2008). The commercial sexual
exploitation of children in New York City: Vol. 1. The CSEC population in New York
City: Size, characteristics, and needs. New York, NY: Center for Court Innovation, &
John Jay College of Criminal Justice, CYU.
Curtol, F., Decarli, S., Di Nicola, A., & Savona, E. (2004). Victims of human trafficking in
Italy: A judicial perspective. International Journal of Victimology, 11, 111-141.
Cwikel, J., Chudakov, B., Paikin, M., Agmon, K., & Belmaker, R. H. (2004). Trafficked female
sex workers awaiting deportation: Comparison with brothel workers. Archive of
Women’s Mental Health, 7, 243-249.
Report of the Task
Force on Trafficking
Cwikel, J., Ilan, K., & Chudakov, B. (2003). Women brothel workers and occupational health
risks. Journal of Epidemiology & Community Health, 57, 809-815.
of Women and Girls
Dalla, R. L. (2000). Exposing the pretty woman myth: A qualitative examination of the lives
of female streetwalking prostitutes. Journal of Sex Research, 37, 344-353.
Dalla, R. L. (2002). Night moves: A qualitative investigation of street-level sex work.
Psychology of Women Quarterly, 26, 63-73.
Dalla, R. L. (2006). “You can’t hustle all your life”: An exploratory investigation of the exit
process among street-level prostituted women. Psychology of Women Quarterly,
30, 276-290.
Dalla, R. L., Xia, Y., & Kennedy, H. (2003). “You just give them what they want and pray
they don’t kill you”: Street-level sex workers’ reports of victimization, personal
resources, and coping strategies. Violence Against Women, 9, 1367-1394.
Danailova-Trainor, G., & Belser, P. (2006). Globalization and the illicit market for human
trafficking: An empirical analysis of supply and demand (Working paper, Special
Action Programme to Combat Forced Labour). Geneva, Switzerland: International
Labour Office. Retrieved from http://www.ilo.org/sapfl/Informationresources/
ILOPublications/ WCMS_081931/lang--en/index.htm
Deb, S., Mukherjee, A., & Mathews, B. (2011). Aggression in sexually abused trafficked
girls and efficacy of intervention. Journal of Interpersonal Violence, 26, 745-768.
DeBoise, C. (2012, January 11). Human trafficking of immigrant transgender women:
Hidden in the shadows [Blog post]. Retrieved from http://www.race-talk.org/
human-trafficking-of-immigrant-transgender-women-hidden-in-the-shadows/
Deci, E. L., & Ryan, R. M. (2000). The “what” and “‘why” of goal pursuits: Human needs
and the self-determination of behavior. Psychological Inquiry, 11, 227-268.
Decker, M. R., McCauley, H. L., Phuengsamran, D., Janyam, S., & Silverman, J. G. (2011).
Sex trafficking, sexual risk, sexually transmitted infection and reproductive health
among female sex workers in Thailand. Journal of Epidemiology & Community
Health, 65, 334-339.
Delaney, S. (2006). Protecting children from sexual exploitation & sexual violence in
disaster & emergency situations. Bangkok, Thailand: ECPAT International.
Retrieved from http://www.ecpat.net/ei/Publications/Care_Protection/Protecting_
Children_from_CSEC_in%20Disaster_ENG.pdf
DeRiviere, L. (2006). A human capital methodology for estimating the lifelong personal
costs of women leaving the sex trade. Feminist Economics, 12, 367-402.
Derks, A. (2000). Combating trafficking in Southeast Asia: A review of policy and
programme responses. Retrieved from http://www.unesco.org/most/migration/
ctsea.pdf
DeStefano, A. M. (2007). The war on human trafficking: U.S. policy assessed. Piscataway,
NJ: Rutgers University Press.
Desyllas, M. C. (2007). A critique of the global trafficking discourse and U.S. policy.
Journal of Sociology & Social Welfare, 34(4), 57-79.
Dettmeijer, C. (2009). Trafficking in human beings: Seventh report of the Dutch National
Rapporteur. Retrieved from http://english.bnrm.nl/reports/seventh/
Dharmadhikari, A. S., Gupta, J., Decker, M. R., Raj, A., & Silverman, J.G. (2009).
Tuberculosis and HIV: A global menace exacerbated via sex trafficking.
International Journal of Infectious Diseases, 13, 543-546.
Di Tommaso, M. L., Shima, I., Strom, S., & Bettio, F. (2009). As bad as it gets: Well-being
deprivation of sexually exploited trafficked women. European Journal of Political
Economy, 25, 143-162.
Dombrowski, S. C., LeMasney, J. W., Ahia, C. E., & Dickson, S. A. (2004). Protecting
children from online sexual predators: Technological, psychoeducational, and
legal considerations. Professional Psychology: Research and Practice, 35, 65-73.
doi:10.1037/0735-7028.35.1.65
76
Domestic Workers United & Data Center. (2006). Home is where the work is: Inside New
York’s domestic work industry. Bronx, NY: Domestic Workers United. Retrieved from
http://www.datacenter.org/reports/homeiswheretheworkis.pdf
Donato, K., & Patterson, E. (2006). Women and men on the move: Undocumented border
crossing. In D. Massey & J. Durand (Eds.), Crossing the border: Research from the
Mexican Migration Project. New York, NY: Russell Sage Foundation.
Dunn Burque, A. (2009). Engaging young men in ending commercial sexual exploitation:
A report, curriculum, and recommended resources. Chicago, IL: CAASE. Retrieved
from http://g.virbcdn.com/_f/files/54/FileItem-149405-CAASEcurriculum1_19.pdf
Durschlag, R., & Goswami, S. (2008). Deconstructing the demand for prostitution:
Preliminary insights from interviews with Chicago men who purchase sex.
Chicago, IL: CAASE. Retrieved from http://www.slaverynomore.org/wp-content/
uploads/2011/07/Deconstructing-the-Demand-for-Prostitution.pdf
Dutton, D. G., & Painter, S. (1993). Emotional attachments in abusive relationships: A test
of traumatic bonding theory. Violence and Victims, 8, 105-120.
Edwards, J. M., Iritani, B. J., & Hallfors, D. D. (2006). Prevalence and correlates of
exchanging sex for drugs or money among adolescents in the United States.
Sexually Transmitted Infections, 82(5), 354-358.
Eisenberger, N. (2012). Broken hearts and broken bones: A neural perspective on the
similarities between social and physical pain. Current Directions in Psychological
Science, 21, 42-47.
Eisenberger, N. I., & Lieberman, M. D. (2004). Why rejection hurts: A common neural alarm
system for physical and social pain. Trends in Cognitive Sciences, 8, 294-300.
Ekberg, G. (2004). The Swedish law that prohibits the purchase of sexual services: Best
practices for prevention of prostitution and trafficking in human beings. Violence
Against Women, 10, 1187-1218.
El-Bassel, N., Witte, S. S., Wada, T., Gilbert, L., & Wallace, J. (2001). Correlates of partner
violence among female street-based sex workers: Substance abuse, history of
childhood abuse, and HIV risks. Aids Patient Care, 15, 41-51.
Ellison, M. C. (2012, November 28). Testimony of Mary C. Ellison, J.D., Director of Policy,
Polaris Project, before the Tom Lantos Human Rights Commission International
Human Trafficking and Forced Labor. Retrieved from http://www.polarisproject.org/
what-we-do/policy-advocacy/federal-policy/congressional-testimony
End Human Trafficking Now. (2010). The Luxor Protocol: Implementation guidelines
to the Athens Ethical Principles: Comprehensive Compliance Programme for
Business. Retrieved from http://www.endhumantraffickingnow.com/wp-content/
uploads/2012/08/The-Luxor-Protocol.pdf
Enriquez, J. (2006, July 3-4). Globalization, militarism and sex trafficking. Paper presented
at the International Meeting of Women World March, Lima, Peru. Retrieved from
http://sisyphe.org/article.php3?id_article=2475
Eriksson, A., & Gavanas, A. (2008). Prostitution in Sweden 2007. Stockholm, Sweden:
Socialstyrelsen. Retrieved from http://www.socialstyrelsen.se/Lists/Artikelkatalog/
Attachments/8806/2008-126-65_200812665.pdf
Estes, R., & Weiner, N. (2001). The commercial sexual exploitation of children in the U.S.,
Canada, and Mexico: Full report of the U.S. national study. Philadelphia, PA:
University of Pennsylvania School of Social Work, Center for the Study of Youth
Policy.
Falb, K. L., McCauley, H. L., Decker, M. R., Sabarwal, S., Gupta, J., & Silverman, J. G.
(2011). Trafficking mechanisms and HIV status among sex-trafficking survivors in
Calcutta, India. International Journal of Gynecology and Obstetrics, 113, 86-87.
Family Violence Prevention Fund. (2005). Turning pain into power: Trafficking survivors’
perspectives on early intervention strategies. San Francisco, CA: Author. Retrieved
from http://www.futureswithoutviolence.org/userfiles/file/ImmigrantWomen/
Turning%20Pain%20intoPower.pdf
Farley, M. (2006). Prostitution, trafficking, and cultural amnesia: What we must not know
in order to keep the business of sexual exploitation running smoothly. Yale Journal
of Law and Feminism, 18, 109-144.
Farley, M., Baral, I., Kiremire, M., & Sezgin, U. (1998). Prostitution in five countries:
Violence and post-traumatic stress disorder. Feminism & Psychology, 8, 405-426.
Farley, M., & Barkan, H. (1998). Prostitution, violence, and posttraumatic stress disorder.
Women & Health, 27, 37-49.
Farley, M., Cotton, A., Lynne, J., Zumbeck, S., Spiwak, F., Reyes, M. E., … Sezgin, U.
(2003). Prostitution and trafficking in nine countries: An update on violence and
posttraumatic stress disorder. Journal of Trauma Practice, 2, 33–74.
Farley, M., Lynne, J., & Cotton, A. J. (2005). Prostitution in Vancouver: Violence and the
colonization of First Nations women. Transcultural Psychiatry, 42, 242-271.
Farley, M., MacLeod, J., Anderson, L., & Golding, J. M. (2011). Attitudes and social
characteristics of men who buy sex in Scotland. Psychological Trauma: Theory,
Research, Practice, and Policy, 3, 369-383.
Farley, M., Matthews, N., Deer, S., Lopez, G., Stark, C., & Hudon, E. (2011). Garden of
truth: The prostitution and trafficking of Native women in Minnesota (A project of
Minnesota Indian Women’s Sexual Assault Coalition and Prostitution Research &
Education). Saint Paul, MN: William Mitchell College of Law.
Farmer, P. (1999). Infections and inequalities: The modern plagues. Berkeley, CA:
University of California Press.
Farr, K. (2005). Sex trafficking: The global market in women and children. Portland, OR:
Worth.
Farrell, A., McDevitt, J., & Fahy, S. (2008). Understanding and improving law enforcement
responses to human trafficking: Final report (Paper 1). Retrieved from http://hdl.
References
handle.net/2047/d10015802
Farrell, A., McDevitt, J., Perry, N., Fahy, S., Chamberlain, M. S., Adams, … Wheeler, K.
(2010). Review of existing estimates of victims of trafficking in the United
States and recommendations for improving research and measurement of
human trafficking. Retrieved from http://www.scribd.com/doc/53048933/
The-Berlin-Turnpike-US-Human-Trafficking-Prevalence-Report
Farrell, A., McDevitt, J., Pfeffer, R., Fahy, S., Owens, C., Dank, M., & Adams, W. (2012).
Identifying challenges to improve the investigation and prosecution of state and
local human trafficking cases (NCJ 238795). Washington, DC: National Institute of
Justice. Retrieved from https://www.ncjrs.gov/pdffiles1/nij/grants/238795.pdf
Federal Bureau of Investigation. (2012). Human trafficking. Retrieved from http://www.
fbi.gov/about-us/investigate/civilrights/human_trafficking
Figley, C. R. (2002). Compassion fatigue: Psychotherapists’ chronic lack of self care.
Psychotherapy in Practice, 58(11), 1433-1441.
Finkelhor, D., & Ormrod, R. (2004, June). Prostitution of juveniles: Patterns from NIBRS.
Juvenile Justice Bulletin. Retrieved from https://www.ncjrs.gov/pdffiles1/
ojjdp/203946.pdf
Finklea, K. M., Fernandes-Alcantara, A. L., & Siskin, A. (2011, June). Sex trafficking of
children in the United States: Overview and issues for Congress. Washington DC:
Congressional Research Service. Retrieved from http://www.fas.org/sgp/crs/misc/
R41878.pdf
Freyd, J. J., DePrince, A. P., & Gleaves, D. H. (2007). The state of betrayal trauma theory:
Reply to McNally – Conceptual issues and future directions. Memory, 15(3),
295-311.
Freyd, J. J., DePrince, A. P., & Zurbriggen, E. L. (2001). Self-reported memory for abuse
depends upon victim-perpetrator relationship. Journal of Trauma and Dissociation,
2, 5-16.
Fuchs, T. (2004). Neurobiology and psychotherapy: An emerging dialogue. Current Opinion
in Psychiatry, 17, 479-485.
Fuchs Ebaugh, H. R. (1988). Becoming an ex: The process of role exit. Chicago, IL:
University of Chicago Press.
Fukushima, A., & Liou, C. C. (2012). Weaving theory and practice: Anti-trafficking
partnerships and the fourth ‘P’ in the human trafficking paradigm (Working Paper
No. 004). Palo Alto, CA: Stanford University, Center on Democracy, Development,
and the Rule of Law.
Gajic-Veljanoski, O., & Stewart, D. (2007). Women trafficked into prostitution:
Determinants, human rights, and health needs. Transcultural Psychiatry, 44,
338-358.
Gammage, S. (2002). Women immigrants in the U.S. labor market: Second-rate jobs in the
first world. In Strum & D. Tarantolo (Eds.), Women immigrants in the United States
(pp. 75-93). Washington, DC: Woodrow Wilson International Center for Scholars
and the Migration Policy Institute. Retrieved from http://www.wilsoncenter.org/
sites/default/files/womenimm_rpt.pdf
Gardner, M., & Steinberg, L. (2005). Peer influence on risk taking, risk preference, and
risky decision making in adolescence and adulthood. Developmental Psychology
41, 625-635. Retrieved from https://secure.uwf.edu/smathews/documents/
peerroleinrisktakinggardnerandsteinberg.pdf
Giobbe, E. (1991). Prostitution: Buying the right to rape. In A.W. Burgess (Ed.), Rape and
sexual assault III: A research handbook (pp. 143-160). New York, NY: Garland
Press.
Giobbe, E. (1993). An analysis of individual, institutional, and cultural pimping. Michigan
Journal of Gender & Law, 1(1), 33-57.
Global Workers Justice Alliance. (2012). United States, visas, H2 statistics: Department
of Labor. Retrieved from http://www.globalworkers.org/country-data-countries/
united-states/department-labor
Finn, M., Sims Blackwell, B., Jackson, L. C., Wolk, J. L., & Oakley, M. B. (2009). Evaluation
Gobin, R. L., & Freyd, J. J. (2009). Betrayal and revictimization: Preliminary findings.
of the demonstration project to address commercial sexual exploitation of children
Psychological Trauma: Theory, Research, Practice, and Policy, 1(3), 242-257.
in Atlanta-Fulton County. Retrieved from https://www.ncjrs.gov/pdffiles1/nij/
grants/226610.pdf
Fischer, K., Vidmar, N., & Ellis, R. (1993). The culture of battering and the role of
mediation in domestic violence cases. SMU Law Review, 46, 2117-2174.
Fiske, S. T., & Linville, P. W. (1980). What does the schema concept buy us? Personality
and Social Psychology Bulletin, 6, 543-557. doi:10.1177/014616728064006
Fiske, S. T., & Taylor, S. E. (1991). Social cognition (2nd ed.). New York, NY: McGraw-Hill.
Fitzpatrick, J. (2003). Trafficking as a human rights violation: The complex intersection of
legal frameworks for conceptualizing and combating trafficking. Michigan Journal
of International Law, 24(4), 1143-1168.
Fletcher, L. E., Pham, P. N., Stover, E., & Vinck, P. (2007). Latino workers and human rights
in the aftermath of Hurricane Katrina. Berkeley Journal of Employment and Labor
Law, 28, 107-152.
Flores, T., & Wells, P. (2010). The slave across the street. Garden City, ID: Ampelon.
Foerster, A. (2009). Contested bodies: Sex trafficking NGOs and transnational politics.
International Feminist Journal of Politics, 11, 1-24.
Fredrickson, B. L., & Roberts, T. (1997). Objectification theory: Toward understanding
women’s lived experiences and mental health risks. Psychology of Women
Quarterly, 21, 173-206.
Free the Slaves & the Human Rights Center. (2004). Hidden slaves: Forced labor in the
United States. Washington, DC & Berkeley, CA: Free the Slaves & Human Rights
Center, University of California Berkeley. Retrieved from http://www.law.berkeley.
edu/files/hiddenslaves_report.pdf
Freedom Network. (2010, September). Labor trafficking is a women’s rights issue.
Retrieved from http://freedomnetworkusa.org
Freyd, J. J. (1994). Betrayal trauma: Traumatic amnesia as an adaptive response to
childhood abuse. Ethics & Behavior, 4(4), 307-329.
Freyd, J. J. (2003). Memory for abuse: What can we learn from a prosecution sample?
Journal of Child Sexual Abuse, 12(2), 97-103.
doi:10.1037/a0017469
Goldenberg, S. M., Rangel, G., Vera, A., Patterson, T. L., Abramovitz, D., Silverman, J.
G., … Strathdee, S. A. (2012). Exploring the impact of underage sex work among
female sex workers in two Mexico-US border cities. AIDS Behavior, 16, 969-981.
Good, G. E., Khairallah, T., & Mintz, L. B. (2009). Wellness and impairment: Moving beyond
noble us and troubled them. Clinical Psychology: Science and Practice, 16, 21-23.
Goodey, J. (2008). Human trafficking: Sketchy data and policy responses. Criminology and
Criminal Justice, 8, 421-442.
Gorkoff, K., & Runner, J. (Eds.). (2003). Being heard: The experiences of young women in
prostitution. Halifax, Nova Scotia: Fernwood.
Gozdziak, E. M., & Bump, M. N. (2008). Data and research on human trafficking:
Bibliography of research-based literature. Washington, DC: National Institute of
Justice.
Gozdziak, E. M., Bump, M. N, Duncan, J., MacDonnell, M., & Loiselle, M. B. (2006). The
trafficked child: Trauma and resilience. Forced Migration Review, 25, 14-15.
Gragg, F., Petta, I., Bernstein, H., Eisen, K., & Quinn, L. (2007). New York prevalence study
of commercially sexually exploited children. Retrieved from http://www.ocfs.state.
ny.us/main/reports/csec-2007.pdf
Graham, D. L. R. (with E. I. Rawlings & R. K. Rigsby). (1994). Loving to survive: Sexual
terror, men’s violence, and women’s lives. New York, NY: New York University Press.
Graham, D. L., Rawlings, E. I., Ihms, K., Latimer, D., Foliano, J., Thompson, A., … Hacker,
R. (1995). A scale for identifying “Stockholm syndrome” reactions in young dating
women: Factor structure, reliability, and validity. Violence and Victims, 10, 3-22.
Grant, J. M., Mottet, L. A., Tanis, J., Harrison, J., Herman, J. L., & Keisling, M. (2011).
Injustice at every turn: A report of the National Transgender Discrimination Survey.
Washington, DC: National Center for Transgender Equality and National Gay
and Lesbian Task Force. Retrieved from http://www.thetaskforce.org/downloads/
reports/reports/ntds_full.pdf
Greene, J. M., Ennett, S. T., & Ringwalt, C. L. (1999). Prevalence and correlates of survival
sex among runaway and homeless youth. American Journal of Public Health, 89,
1406–1409.
77
Grieco, E. M., Trevelyan, E., Larsen, L., Acosta, Y. D., Gambino, C., de la Cruz,
P., … Walters, N. (2012). The size, place of birth, and geographic distribution
of the foreign-born population in the United States: 1960-2010 (Working Paper
No. 96). Retrieved from U.S. Census Bureau website: www.census.gov/people/
publications/popworkingpapers.html
Gupta, J., Raj, A., Decker, M. R., Reed, E., & Silverman, J. G. (2009). HIV vulnerabilities
of sex-trafficked Indian women and girls. International Journal of Gynecology and
Obstetrics, 107, 30-34.
Gushulak, B. D., & MacPherson, D. W. (2000). Health issues associated with the smuggling
and trafficking of migrants. Journal of Immigrant Health, 2, 67-78.
Hainmueller, J., Hiscox, M. J., & Sequeira, S. (2011, April). Consumer demand for the fair
trade label: Evidence from a field experiment. Retrieved from http://ssrn.com/
abstract=1801942
Report of the Task
Force on Trafficking
Hansen, E., & Donohoe, M. (2003). Health issues of migrant and seasonal farmworkers.
Journal of Health Care for the Poor and Underserved, 14, 153-164.
of Women and Girls
Harm Reduction Coalition. (n.d.). Principles of harm reduction. Retrieved from http://
harmreduction.org/about-us/principles-of-harm-reduction
Harris, M., & Fallot, R. D. (2001). Using trauma theory to design service systems: New
directions for mental health services. San Francisco, CA: Jossey-Bass.
Hart, S. M. (2012). Destinations: A comparison of sex trafficking in India and the United
States. University of Colorado Law Review, 83, 1149-1180.
Harvey, M. R., & Tummala-Narra, P. (2007). Sources and expression of resilience in trauma
survivors: Ecological theory, multicultural perspectives. Journal of Aggression,
Maltreatment, & Trauma, 14(1-2), 1-7.
Hay, N. (2008). Domestic minor sex trafficking assessment report: Dallas, Texas. Arlington,
VA: Shared Hope International. Retrieved from http://sharedhope.org/wp-content/
uploads/2012/09/Dallas_PrinterFriendly2.pdf
Hendricks, T. (2007, March 12). On the border. San Francisco Chronicle. Retrieved from
http://www.sfgate.com/cgibin/article.cgi?f=/c/a/2007/03/12/MNGEUOJLNF1.
DTL&ao=all
Herman, J. L. (1992). Complex PTSD: A syndrome in survivors of prolonged and repeated
trauma. Journal of Traumatic Stress, 5, 377­3 91.
Herman, J. (1997). Trauma and recovery: The aftermath of violence from domestic abuse to
political terror. New York, NY: Basic Books.
Herman, J. L. (2003). The mental health of crime victims: Impact of legal intervention.
Journal of Traumatic Stress, 16, 159-166.
Herman, J. L. (2005). Justice from the victim’s perspective. Violence Against Women, 11,
571-602.
Hernandez, A. (2003, January 9, 10, 11). The sex trafficking of children in San Diego
County (Three-part series). Mexico City: El Universal. English-language version
retrieved from http://www.libertadlatina.org/US_Sex_Trafficking_San_Diego_
Case_01122003_English.htm
Heyzer, N. (2002, November). Combating trafficking in women and children: A gender and
SAGE, a peer leadership model among prostitution survivors. NACSW Convention
Proceedings, 1-12.
Hsu, K. S. (2007). Masters and servants in America: The ineffectiveness of current United
States anti-trafficking policy in protecting victims of trafficking for the purposes
of domestic servitude. Georgetown Journal on Poverty Law & Policy, 15, 489-510.
Huffman, S. A., Veen, J., Hennink, M. M., & McFarland, D. A. (2012). Exploitation,
vulnerability to tuberculosis and access to treatment among Uzbek labor migrants
in Kazakhstan. Social Science & Medicine, 74, 864-872.
Hughes, D. (2000). The “Natasha” trade: The transnational shadow market of trafficking
in women. Journal of International Affairs, 53(2), 625-651.
Hughes, D. (2002, December 13-14). Trafficking of children for prostitution. Paper
presented at the Protecting Our Children: Working Together to End Child
Prostitution Conference, Washington DC. Retrieved from http://www.uri.edu/artsci/
wms/hughes/trafficking_children
Hughes, D., Chon, K., & Ellerman, D. (2007). Modern-day comfort women: The U.S. military,
transnational crime, and the trafficking of women. Violence Against Women, 13,
901-922. Retrieved from http://www.uri.edu/artsci/wms/hughes/pubtrfrep.htm
Hughes, D., & Roche, C. M. (1999). Making the harm visible: Global sexual exploitation
of women and girls - Speaking out and providing services. North Amherst, MA:
Coalition Against Trafficking in Women. Retrieved from http://www.uri.edu/artsci/
wms/hughes/mhvtoc.htm
Human Rights Center. (2005). Freedom denied: Forced labor in California. Berkeley, CA:
Author. Retrieved from http://www.oas.org/atip/country%20specific/Forced%20
Labor%20in%20California.pdf
Human Rights Watch. (2001). Hidden in the home: Abuse of domestic workers with special
visas in the United States. New York, NY: Author. Retrieved from http://www.hrw.
org/reports/2010/03/17/hidden-home
Human Rights Watch. (2012). Cultivating fear: The vulnerability of immigrant farmworkers
in the U.S. to sexual violence and sexual harassment. New York, NY: Author.
Retrieved from http://www.hrw.org/sites/default/files/reports/us0512ForUpload_1.
pdf
Human Trafficking Law Project (HTLP). (2013). Human trafficking database. Ann Arbor,
MI: University of Michigan Law School. Retrieved from http://www.law.umich.edu/
clinical/HuTrafficCases/Pages/searchdatabase.aspx
Hunt, S. (2006). Final Report—Violence in the lives of sexually exploited youth and adult
sex workers in BC: Provincial research. New Westminster, BC: Justice Institute of
British Columbia, Centre for Leadership and Community Learning. Retrieved from
http://www.peers.bc.ca/images/violence_report1106.pdf
Hwang, S., & Bedford, O. (2003). Precursors and pathways to adolescent prostitution in
Taiwan. Journal of Sex Research, 40, 201-210.
Hynes, H. P. (2002). The United States: Migration and trafficking in women. In J. G.
Raymond et al. (Eds.), A comparative study of women trafficked in the migration
human rights framework. Paper presented at the Globalization Research Center
process: Patterns, profiles and health consequences of sexual exploitation in five
Conference, Honolulu, HI. Retrieved from http://www.childtrafficking.org/pdf/user/
countries (Indonesia, the Philippines, Thailand, Venezuela and the United States).
unifem_gender_and_human_rights_framework.pdf
North Amherst, MA: Coalition Against Trafficking in Women. Retrieved from http://
Hiscox, M. J., Broukhim, M., Litwin, C., & Woloski, A. (2011). Consumer demand for fair
labor standards: Evidence from a field experiment on eBay. Retrieved from http://
dx.doi.org/10.2139/ssrn.1811788
Hiscox, M. J., & Smyth, N. (2011). Is there consumer demand for fair labor standards?
Evidence from a field experiment. Retrieved from http://dx.doi.org/10.2139/
ssrn.1820642
Hodge, D. (2008). Sexual trafficking in the United States: A domestic problem with
transnational dimensions. Social Work, 53, 143-152.
Holmes, S. M. (2007). “Oaxacans like to work bent over”: The naturalization of social
suffering among berry farm workers. International Migration, 45, 39-68.
Holt, T. J., & Blevins, K. R. (2007). Examining sex work from the client’s perspective:
Assessing johns using online data. Deviant Behavior, 28, 333-54.
Hopper, E. (2004). Underidentification of human trafficking victims in the United States.
Journal of Social Work Research and Evaluation, 5(2), 125-136.
Hopper, E., & Hidalgo, J. (2006). Invisible chains: Psychological coercion of human
trafficking victims. Intercultural Human Rights Review, 1, 185-209.
Hossain, M., Zimmerman, C., Abas, M., Light, M., & Watts, C. (2010). The relationship
78
Hotaling, N., Burris, A., Johnson, J., Bird, Y., & Melbye, K. (2003). Been there, done that:
action.web.ca/home/catw/attach/CATW%20Comparative%20Study%202002.pdf
Hynes, H. P., & Raymond, J. G. (2002). Put in harm’s way: The neglected health
consequences of sex trafficking in the United States. In J. Silliman & A.
Bhattacharjee (Eds.), Policing the national body: Sex, race, and criminalization
(pp. 197-229). Cambridge, MA: South End.
Iman, J., Fullwood, C., Paz, N., Daphne, W., & Hassan, S. (2009). Girls do what they have
to do to survive: Illuminating methods used by girls in the sex trade and street
economy to fight back and heal: A participatory research study of resilience and
resistance. Chicago, IL: Young Women’s Empowerment Project.
International Labour Organization. (2012). Stopping forced labour and slavery-like
practices: The ILO strategy. Geneva, Switzerland: Author. Retrieved from http://
www.ilo.org/global/topics/forced-labour/publications/WCMS_203447/lang--en/
index.htm
International Organization for Migration. (2009). Caring for trafficked persons: Guidance
for health providers. Retrieved from http://publications.iom.int/bookstore/free/
CT_Handbook.pdf
International Organization for Migration. (2010). World migration report 2010. The
of trauma to mental disorders among trafficked and sexually exploited girls and
future of migration: Building capacities for change. Geneva, Switzerland: Author.
women. American Journal of Public Health, 100, 2442-2449.
Retrieved from http://publications.iom.int/bookstore/free/WMR_2010_ENGLISH.pdf
Israel, B. A., Schulz, A. J., Parker, E. A., & Becker, A. B. (1998). Review of community-based
research: Assessing partnership approaches to improve public health. Annual
Review of Public Health, 19, 173–202.
Israel, B. A., Schulz, A. J., Parker, E. A., Becker, A. B., Allen, A., & Guzman, J. R. (2003).
Critical issues in developing and following community-based participatory
research principles. In M. Minkler & N. Wallerstein, (Eds.), Community-based
participatory research for health (pp. 56-73). San Francisco, CA: Jossey-Bass.
Jahic, G., & Finckenauer, J. O. (2005). Representations and misrepresentations of human
trafficking. Trends in Organized Crime, 8(3), 24-40.
James, J., & Meyerding, J. (1977). Early sexual experience and prostitution. American
Journal of Psychiatry, 134, 1381-1385.
Janus, M. D., Archambault, F. X., Brown, S. W., & Welsh, L. A. (1995). Physical abuse in
Canadian runaway adolescents. Child Abuse & Neglect, 19, 433-447.
References
Janus, M., McCormack, A. Burgess, A., & Hartman, C. (1987). Adolescent runaways: Causes
and consequences. Lexington, MA: Lexington Books.
Jenaro, C., Flores, N., & Arias, B. (2007). Burnout and coping in human services
practitioners. Professional Psychology: Research and Practice, 38(1), 80-87.
doi:10.1037/0735-7028.38.1.80
Johnson, A. L. (2012). A perfect storm: The U.S. anti-trafficking regime’s failure to stop the
sex trafficking of American Indian women and girls. Columbia Human Rights Law
Review, 43(2), 619-710.
Jones, C., & Yousefzadeh, P. (2006, April). Victims of human trafficking in the Midwest:
2003-2005 needs assessment and program evaluation. Chicago, IL: The MidAmerica Institute on Poverty - Heartland Alliance.
Jordan, A. (2011, May). Fact or fiction: What do we really know about human trafficking?
Kim, K., & Hreshchyshyn, K. (2004). Human trafficking private right of action: Civil rights
for trafficked persons in the United States. Hastings Women’s Law Journal, 16(1),
1-36.
Kimble, M. O., Fleming, K., Bandy, C., & Zambetti, A. (2010). Attention to novel and target
stimuli in trauma survivors. Psychiatry Research, 178, 501-506.
Kingsley, C., & Mark, M. (2000). Sacred lives: Canadian Aboriginal children and youth
speak out about sexual exploitation. Toronto, ON: Save the Children Canada.
Retrieved from http://www.gov.mb.ca/fs/traciastrust/pubs/sacred_lives.pdf
Kissinger, P., Liddon, N., Schmidt, N., Curtin, E., Salinas, O., & Narvaez, A. (2008). HIV/
STI risk behaviors among Latino migrant workers in New Orleans post-hurricane
Katrina disaster. Sexually Transmitted Diseases, 35, 924-929.
Kliner, M., & Stroud, L. (2012). Psychological and health impact of working with victims of
sex trafficking. Journal of Occupational Health, 54, 9-15.
Kotrla, K. (2010). Domestic minor sex trafficking in the United States. Social Work, 55(2),
181-187.
Kramer, L. A., & Berg, E. C. (2003). A survival analysis of timing of entry into prostitution:
The differential impact of race, educational level, and childhood/adolescent risk
factors. Sociological Inquiry, 73(4), 511–528.
Kreston, S. (2000, November/December). Prostituted children: Not an innocent image. The
Prosecutor, 34(6), 37-41.
Kubany, E. S., Hill, E. E., Owens, J. A., Iannce-Spencer, C., McCaig, M. A., Tremayne, K. J.,
& Williams, P. L. (2004). Cognitive trauma therapy for battered women with PTSD
(CTT-BW). Journal of Consulting and Clinical Psychology, 72(1), 3-18. doi:10.1037/
a0023822
Kullman, S. (2012). The conflict of goals in European prostitution legislation. Paper
(Issue Brief No. 3). Washington, DC: American University, Washington College of
presented at seminar for Institut für Politikwissenschaft, Universität Bern.
Law, Center for Human Rights and Humanitarian Law.
Retrieved from http://www.samuelkullmann.ch/Samuel_Kullmann/Publikationen_
Joshi, A. (2002). The face of human trafficking. Hastings Women’s Law Journal, 13, 18-40.
Retrieved from http://www.childtrafficking.com/Docs/joshi_2002__the_face_of_
hum.pdf
Judge, A. M., & Murphy, J. A. (2011). The commercial sexual exploitation of children and
adolescents in the United States: A call to action for psychology and law. American
Psychology-Law Society News, 31(3), 24-28. Retrieved from http://www.ap-ls.org/
publications/newsletters/aplsnews.fall2011.pdf
Julich, S. (2005). Stockholm Syndrome and child sexual abuse. Journal of Child Sexual
Abuse, 14, 107-129.
Jung, Y. E., Song, J. M., Chong, J., Seo, H. J., & Chae, J. H. (2008). Symptoms of
posttraumatic stress disorder and mental health in women who escaped
prostitution and helping activists in shelters. Yonsei Medical Journal, 49, 372-382.
Justice Resource Institute. (2012). My life my choice: Survivor mentoring. Retrieved from
http://www.jri.org/mylife/Services-Survivor-Mentoring.php
files/Conflict%20of%20Goals.pdf
Kurtz, S. P., Surratt, H. L., Inciardi, J. A., & Kiley, M. C. (2004). Sex work and “date”
violence. Violence Against Women, 10, 357-385.
Kusmer, K. (2011, May 4). Feds announce bust of Latin American-Midwestern sex
trafficking ring. Associated Press/WBEZ91.5. Retrieved from http://www.wbez.org/
story/feds-announce-bust-latin-american-midwestern-sex-trafficking-ring-86074
Kyckelhahn, T., Beck, A., & Cohen, T. (2009). Characteristics of suspected human
trafficking incidents 2007-2008 (Bureau of Justice Statistics special report).
Washington, DC: U.S. Department of Justice. Retrieved from http://files.meetup.
com/1160329/POST_on_Site.pdf
Laboratory to Combat Human Trafficking. (n.d.). History of the 4P framework. Retrieved
from www.combathumantrafficking.org/history/4pframework
Laboratory to Combat Human Trafficking. (2012). Prostitution-related arrests in the city
and county of Denver: Who pays? Retrieved from http://www.ccasa.org/wp-content/
Kaczorowski, J. A., Williams, A. S., Smith, T. F., Fallah, N., Mendez, J. L., & Nelson-Gray, R.
uploads/2011/04/Prostitution-and-denvers-criminal-justice-system-who-pays.pdf
(2011). Adapting clinical services to accommodate needs of refugee populations.
Laczko, F., & Danailova-Trainor, G. (2009). Trafficking in persons and human development:
Professional Psychology: Research and Practice, 42, 361-367. doi:10.1037/
a0025022
Kara, S. (2007). Decentralizing the fight against human trafficking in the United States:
Series 51.
Laczko, F., & Gozdziak, E. (Eds.). (2005). Data and research on human trafficking: A global
The need for greater involvement in fighting human trafficking by state agencies
survey. International Organization on Migration. Retrieved from http://www.iom.
and local non-governmental organizations. Cardozo Journal of Law & Gender, 13,
int/jahia/webdav/site/myjahiasite/shared/shared/mainsite/published_docs/books/
756–673.
Kara, S. (2010). Sex trafficking: Inside the business of modern slavery. New York:
University of Columbia Press.
Karama Movement. (2010). Report on refugee and stateless women across the Arab region.
Stories of: Dream of return, the fear of trafficking, and discriminatory laws.
Retrieved from http://www.el-karama.org/sites/default/files/karama_refugee_
report_eng.pdf
Kaschak, E. (1992). Engendered lives: A new psychology of women’s experience. New York,
NY: Basic Books.
Kennedy, M. A., Klein, C., Bristowe, J. T. K., Cooper, B. S., & Yuille, J. C. (2007). Routes
of recruitment: Pimps’ techniques and other circumstances that lead to street
prostitution. Journal of Aggression, Maltreatment & Trauma, 15(2), 1-19.
Kennedy, M., & Pucci, N. (2007). Domestic minor sex trafficking assessment report: Las
Vegas, Nevada. Arlington, VA: Shared Hope International. Retrieved from http://
www.sharedhope.org/Portals/0/Documents/LasVegas_PrinterFriendly.pdf
Kim, J. (2010). Trafficked: Domestic violence, exploitation in marriage, and the foreignbride industry. Virginia Journal of International Law, 51, 443-506.
Kim, K. (2011). The coercion of trafficked workers. Iowa Law Review, 96(409), 409-474.
79
Towards a more integrated policy response. Human Development Research Paper,
data_res_human.pdf
Langer, E. J. (1990). Mindfulness. Reading, PA: Da Capo Books.
Langer, E. J., & Abelson, R. P. (1974). A patient by any other name … Clinician group
difference in labeling bias. Journal of Consulting and Clinical Psychology, 42(1),
4-9.
Lee, T. (2004). In and out: A survivor’s memoir of stripping. In R. Whisnant & C. Stark
(Eds.), Not for sale: Feminists resisting prostitution and pornography (pp. 56-63).
North Melbourne, Australia: Spinifex Press.
Lloyd, R. (2005). Acceptable victims? Sexually exploited youth in the U.S. Encounter:
Education for Meaning and Social Justice, 18(3), 6-18.
Lloyd, R. (2008). From victim to survivor, from survivor to leader: The importance
of leadership programming and opportunities for commercially sexually
exploited and trafficked young women & girls. New York, NY: GEMS – Girls
Educational and Mentoring Services. Retrieved from http://www.gems-girls.org/
from-victim-to-survivor-from-survivor-to-leader
Lloyd, R. (2011). Girls like us. New York, NY: HarperCollins.
Logan, T., Walker, R., & Hunt, G. (2009). Understanding human trafficking in the United
States. Trauma, Violence, and Abuse, 10(1), 3-30.
Louie, M. C. Y. (2001). Sweatshop warriors: Immigrant women workers take on the global
factory. Cambridge, MA: South End Press.
Loza, O., Strathdee, S. A., Lozada, R., Staines, H., Ojeda, V. D., Martinez, … Patterson, T. L.
(2010). Correlates of early versus later initiation into sex work in two Mexico-U.S.
border cities. Journal of Adolescent Health, 46, 37-44.
Lozano, F., & Lopez, M. (2010). Border enforcement and selection of Mexican immigrants to
the United States (IZA Discussion Paper 4898). Retrieved from http://ftp.iza.org/
dp4898.pdf
Luxenberg, T., Spinazzola, J., & van der Kolk, B. A. (2001). Complex trauma and disorders
of extreme stress (DESNOS) diagnosis. Part 1: Assessment. Directions in
Psychiatry, 21(25), 373-392.
MacKinnon, C. (2005). Women’s lives, men’s laws. Boston, MA: Belknap Press of Harvard
University Press.
Report of the Task
Force on Trafficking
MacKinnon, C. A. (2011). Trafficking, prostitution, and inequality. Harvard Civil Rights
-Civil Liberties Law Review, 46, 271-309.
of Women and Girls
Macy, R. J., & Johns, N. (2011). Aftercare services for international sex trafficking
survivors: Informing U.S. service and program development in an emerging
practice area. Trauma, Violence, & Abuse, 12(2), 87-98.
Månsson, S. A., & Hedin, U. C. (1999). Breaking the Matthew effect on women leaving
prostitution. International Journal of Social Welfare, 8, 67-77.
Marlatt, G. A., Larimer, M. E., & Witkiewitz, K. (2012). Harm reduction: Pragmatic
strategies for managing high-risk behaviors (2nd ed.) New York, NY: Guilford
Press.
Maslow, A. (1954). Motivation and personality. New York, NY: Harper.
Massachusetts Department of Education. (1989). Changing schools and communities:
A systematic approach to dropout prevention. Retrieved from http://archive.org/
details/changingschoolsc00mass
Massachusetts Department of Elementary and Secondary Education. (2009). Dropout
reduction: Prevention, intervention, and recovery. Retrieved from http://www.doe.
mass.edu/dropout/overview.html?section=riskfactors
McCann, L., & Pearlman, L. A. (1990). Vicarious traumatization: A framework for
understanding the psychological effects of work with victims. Journal of Traumatic
Stress, 3(1), 216-149.
McClanahan, S. F., McClelland, G. M., Abram, K. M., & Teplin, L. A. (1999). Pathways into
prostitution among female jail detainees and their implications for mental health
services. Psychiatric Services, 50(12), 1-11.
McEwen, B. S. (2002). The end of stress as we know it. Washington, DC: Joseph Henry
Press.
McGraw, M. (2009, December 15). Decades pass, yet abuse cases persist. The Kansas City
Star, page A8.
McLeroy, K. R., Bibeau, D., Steckler, A., & Glanz, K. (1988). An ecological perspective on
health promotion programs. Health Education Quarterly, 15, 351-377.
Meichenbaum, D. (2007, May). Self-care for trauma psychotherapists and caregivers:
Individual, social and organizational interventions. Paper presented at the 11th
Annual Conference of the Melissa Institute for Violence Prevention and Treatment
of Victims of Violence, Miami, FL. Retrieved from http://www.melissainstitute.org/
documents/Meichenbaum_SelfCare_11thconf.pdf
Menaker, T. A., & Miller, A. K. (2012). Culpability attributions towards juvenile female
prostitutes. Child Abuse Review, 22, 169-181. doi:10.1002/car.2204
Meyer, L. B. (2003). Economic globalization and women’s status in the labor market:
A cross-national investigation of occupational sex segregation and inequality.
Sociological Quarterly, 44(3), 351-383.
Microsoft News Center. (2012, July 18). Shedding light on the role of technology in
child sex trafficking. Retrieved from http://www.microsoft.com/en-us/news/
features/2012/jul12/07-18childsextraffickingresearch.aspx
Miko, F., & Park, G. (2002). Trafficking in women and children: The U.S. and international
response. Washington, DC: Congressional Research Service. Retrieved from http://
fpc.state.gov/documents/organization/9107.pdf
Miller, E., Decker, M. R., Silverman, J. G., & Raj, A. (2007). Migration, sexual exploitation,
and women’s health: A case report from a community health center. Violence
Against Women, 13(5), 486-497.
Minkler, M., & Wallerstein, N. (2008). Community-based participatory research for health:
From process to outcomes (2nd ed.). San Francisco, CA: Jossey-Bass.
Mitchell, K. J., Finkelhor, D., & Wolak, J. (2010). Conceptualizing juvenile prostitution as
child maltreatment: Findings from the National Juvenile Prostitution Study. Child
Maltreatment, 15(1), 18-36.
80
Moe, A. M. (2004). Blurring the boundaries: Women’s criminality in the context of abuse.
Women’s Studies Quarterly, 32(3/4), 116-138. Retrieved from http://www.jstor.org/
stable/40004583
Molnar, B., Shade, S., Kral, A., Booth, R., & Watters, J. (1998). Suicidal behavior and
sexual/physical abuse among street youth. Child Abuse & Neglect, 22(3), 213-222.
Monto, M. A., & Garcia, S. (2001). Recidivism among the customers of female street
prostitutes: Do intervention programs help? Western Criminology Review, 3(2).
Retrieved from http://wcr.sonoma.edu/v3n2/monto.html
Moossy, R. (2008). Sex trafficking: Identifying cases and victims. NIJ Journal, 262, 2-11.
Morawska, E. (2007) Trafficking into and from Eastern Europe. In M. Lee (Ed.), Human
trafficking (pp. 92-115). Collumpton, UK: Willan.
Mounier, C., & Andujo, E. (2003). Defensive functioning of homeless youth in relation to
experiences of child maltreatment and cumulative victimization. Child Abuse &
Neglect, 27(10), 1187-1204.
Murphy, L. S. (2010). Understanding the social and economic contexts surrounding women
engaged in street-level prostitution. Issues in Mental Health Nursing, 31, 75-784.
Namnyak, M., Tufton, N., Szekely, R., Toal, M., Worboys, S., & Sampson, E. L. (2008).
Stockholm Syndrome: Psychiatric diagnosis or urban myth? Acta Psychiatrica
Scandinavica, 117, 4-11.
Napoli, M., Gerdes, K., & DeSouza-Rowland, S. (2001). Treatment of prostitution
using integrative therapy techniques: A case study. Journal of Contemporary
Psychotherapy, 31(2), 71-87.
National Criminal Justice Reference Service. (2009, April). Evaluation of the demonstration
project to address commercial sexual exploitation of children in Atlanta-Fulton
County. Retrieved from https://www.ncjrs.gov/pdffiles1/nij/grants/226610.pdf
National Gang Intelligence Center. (2011). National gang threat assessment: Emerging
trends. Retrieved from http://www.fbi.gov/stats-services/publications/2011national-gang-threat-assessment/2011-national-gang-threat-assessmentemerging-trends
National Human Trafficking Resource Center. (2010, November 10). National
Human Trafficking Resource Center Newsletter. Washington DC: Author.
Retrieved from http://act.polarisproject.org/o/5417/t/0/blastContent.
jsp?email_blast_KEY=1160644
National Human Trafficking Resource Center. (2011, May 16). National Human Trafficking
Resource Center Newsletter. Washington DC: Author. Retrieved from http://act.
polarisproject.org/o/5417/t/0/blastContent.jsp?email_blast_KEY=1164151
Newman, G. (2006). The exploitation of trafficked women (Problem-Specific Guides Series
No. 38). Washington, DC: U.S. Department of Justice. Retrieved from http://www.
cops.usdoj.gov/Publications/e02061007.pdf
Nikoli -Ristanovi , V. (2002a). Sex trafficking: The impact of war, militarism and
globalization in Eastern Europe. Globalizacija.com, Journal for Political Theory and
Research on Globalisation, Development, and Gender issues. Retrieved from http://
www.globalizacija.com/doc_en/e0058sim.htm
Nikoli -Ristanovi , V. (2002b). Social change, gender, and violence: Post-Communist and
war-affected societies. Boston, MA: Kluwer.
Norcross, J. C., & Barnett, J. E. (2008, Spring). Self-care as ethical imperative. The
Register Report. Retrieved from http://www.nationalregister.org/trr_spring08_
norcross.html
Norton-Hawk, M. (2002). The lifecourse of prostitution. Women, Girls & Criminal Justice,
3(1), 1, 7-9.
O’Connell Davidson, J. (2006). Men, middlemen and migrants: The demand side of sex
trafficking. Eurozine. Retrieved from http://www.eurozine.com/articles/2006-0727-davidson-en.html.
O’Leary, C., & Howard, O. (2001). The prostitution of women and girls in metropolitan
Chicago: A preliminary prevalence report. Chicago, IL: Center for Impact Research.
Retrieved from http://www.impactresearch.org/documents/prostitutionreport.pdf
Olson, H., Burgess, D., & Streissguth, A. (1992). Fetal alcohol syndrome (FAS) and fetal
alcohol effects (FAE): A lifespan view, with implications for early intervention, Zero
to Three: National Center for Clinical Infant Programs, 13(1), 24-29.
O’Neill Richard, A. (2000). International trafficking in women to the United States: A
contemporary manifestation of slavery and organized crime. Washington D.C.:
U.S. Department of State, Bureau of Intelligence & Research, DCI Exceptional
Intelligence Analyst Program. Retrieved from https://www.cia.gov/library/center-forthe-study-of-intelligence/csi-publications/books-and-monographs/trafficking.pdf
Oram, S., Stöckl, H., Busza, J., Howard, L. M., & Zimmerman, C. (2012). Prevalence and
risk of violence and the physical, mental, and sexual health problems associated
with human trafficking: A systematic review. PLoS Med, 9(5). Retrieved from
http://dx.doi.org/10.137/journal.pmed.1001224
Orhant, M. (2002). Article I: Trafficking in persons. In E. Murphy & A. Hendrix-Jenkins
(Eds.), Reproductive health and rights: Reaching the hardly reached (pp. 1-12).
Retrieved from www.path.org/files/RHR-Article_1.pdf
Othman, Z. (2006). Human (in)security, human trafficking, and security in Malaysia. In
K. Beeks & D. Amir (Eds.), Trafficking and the global sex industry (pp. 47-60).
Lanham, MD: Lexington Books.
Owens Bullard, B. (2011, Fall). Intimate partner and intrafamilial exploitation: How the
intersections of domestic violence and human trafficking can profoundly affect our
work. The Voice: The Journal of the Battered Women’s Movement, 42-45. Retrieved
References
from http://www.ncadv.org/
Page, J., & Adams, R. H., Jr. (2003, December). International migration, remittances,
and poverty in developing countries (World Bank Policy Research Working
Potterat, J. J., Brewer, D. D., Muth, S. Q., Rothenberg, R. B., Woodhouse, D. E., Muth, J.
B., … Brody, S. (2004). Mortality in a long-term open cohort of prostitute women.
American Journal of Epidemiology, 159, 78-795.
Poudel, P., & Carryer, J. (2000). Girl-trafficking, HIV/AIDS, and the position of women in
Nepal. Gender and Development, 8(2), 74-79.
Preibisch, K., & Hennebry, J. (2011). Temporary migration, chronic effects: The health of
international migrant workers in Canada. Canadian Medical Association Journal,
183(9), 1033-1038.
Priebe, A., & Suhr, C. (2005, September). Hidden in plain view: The commercial sexual
exploitation of girls in Atlanta. Atlanta, GA: Atlanta Women’s Agenda. Retrieved
from http://www.childtrafficking.com/Docs/atlanta_women_05_girls_0109.pdf
Prochaska, J. O., DiClemente, C. C., & Norcross, J. C. (1992). In search of how people
change: Applications to addictive behavior. American Psychologist, 47, 1102-1114.
Putnam, F. W. (1993). Dissociative disorders in children: Behavioral profiles and problems.
Child Abuse & Neglect, 17, 39-45.
Putnam, F. W. (1995). Traumatic stress and pathological dissociation. In G. P. Chrousos,
Paper No. 3179). Retrieved from http://papers.ssrn.com/sol3/papers.
R. McCarty, K., Pacak, G. Cizza, E. Sternberg, P. W. Gold, & R. Kvetansky (Eds.),
cfm?abstract_id=636598
Annals of the New York Academy of Sciences, Vol. 771. Stress: Basic mechanisms
Patel, R. B., Ahn, R., & Burke, T. F. (2010). Human trafficking in the emergency
department. Western Journal of Emergency Medicine, 11(5), 402-404.
Patterson, O. (2011, August 26-28). Trafficking, gender & slavery: Past and present. In
The legal parameters of slavery: Historical to the contemporary. Cambridge, MA:
Harvard Law School, Houston Institute for Race and Justice. Retrieved from http://
scholar.harvard.edu/files/patterson/files/trafficking_gender_slavery_12_20_11_
cambria__autosaved_.pdf
Patterson, T. D. (2012). NCAVC Juvenile Prostitution [Database]. Unpublished raw data.
Peng, Y. (2005). “Of course they claim they were coerced”: On voluntary prostitution,
contingent consent, and the modified whore stigma. Journal of International
Women’s Studies, 7(2), 17-35.
and clinical implications (pp. 708-715). New York, NY: New York Academy of
Sciences.
Putnam, F. W., Helmers, K., Horowitz, L. A., & Trickett, P. K. (1995). Hypnotizability and
dissociativity in sexually abused girls. Child Abuse & Neglect, 19(5), 645-655.
Quina, K., & Carlson, N. (1989). Rape, incest, and sexual harassment. New York, NY:
Greenwood.
Rabinovitch, J. (2003). The Prostitutes’ Empowerment, Education and Resource Society.
In M. Farley (Ed.), Prostitution, trafficking, and traumatic stress (pp. 255-266).
Binghamton, NY: Haworth.
Raphael, J. (2004). Listening to Olivia: Violence, poverty, and prostitution. Boston, MA:
Northeastern University Press.
Perdue, T. R., Williamson, C., Ventura, L. A., Hairston, T. R., Osborne, L. T. C., Laux,
Raphael, J. & Ashley, J. (2008). Domestic sex trafficking of Chicago women and girls.
J. M, … Nathan, V. M. (2012). Offenders who are mothers with and without
Illinois Criminal Justice Information Authority. Retrieved from http://www.law.
experience in prostitution: Differences in historical trauma, current stressors, and
physical and mental health differences. Women’s Health Issues, 22(2), 195-200.
Peres, J., & Nasello, A.G. (2008). Psychotherapy and neuroscience: Towards closer
integration. International Journal of Psychology, 43(6), 943-957.
Perron, B. E., & Hiltz, B. S. (2006). Burnout and secondary trauma among forensic
interviewers of abused children. Child and Adolescent Social Work Journal, 23(2),
216-231.
Pierce, A. (2009). Shattered hearts: The commercial sexual exploitation of American
Indian women and girls in Minnesota. Minneapolis, MN: Minnesota Indian Women’s
Resource Center. Retrieved from http://www.miwrc.org/shattered_hearts_full_
report-web_version.pdf
Pierce, A. (2012). American Indian adolescent girls: Vulnerability to sex trafficking,
intervention strategies. American Indian and Alaska Native Mental Health
Research, 19(1), 37-56.
Pierce, A., & Koepplinger, S. (2011, October). New language, old problem: Sex trafficking
ex-pimps in Chicago. Chicago, IL: DePaul University College of Law, Schiller
DuCanto & Fleck Family Law Center. Retrieved from http://newsroom.depaul.edu/
PDF/FAMILY_LAW_CENTER_REPORT-final.pdf
Raphael, J., & Shapiro, D., (2002). Sisters speak out: The lives and needs of prostituted
women in Chicago—A research study. Chicago, IL: Center for Impact Research.
Retrieved from http://www.impactresearch.org/documents/sistersspeakout.pdf
Raphael, J., & Shapiro, D. (2004). Violence in indoor and outdoor prostitution venues.
Violence Against Women, 10(2), 126-139.
Raymond, J. G. (2004). Prostitution on demand: Legalizing the buyers as sexual
consumers. Violence Against Women, 10(10), 1156-1186.
Raymond, J. G., D’Cunha, J., Dzuhayatin, S. R., Hynes, H. P., Rodriguez, Z. R., & Santos,
A. (2002). A comparative study of women trafficked in the migration process:
Patterns, profiles and health consequences of sexual exploitation in five countries
of American Indian women and children. Harrisburg, PA: VAWnet, a project of the
(Indonesia, the Philippines, Thailand, Venezuela and the United States). N.
National Resource Center on Domestic Violence. Retrieved from http://www.vawnet.org
Amherst, MA: Coalition Against Trafficking in Women. Retrieved from http://action.
Piper, N. (2003). Feminization of labor migration as violence against women: International,
regional, and local nongovernmental organization responses in Asia. Violence
Against Women, 9(6), 723-745.
Polaris Project. (2011a). Comprehensive human trafficking assessment. Washington,
DC: National Human Trafficking Resource Center. Retrieved from http://www.
polarisproject.org/resources/tools-for-service-providers-and-law-enforcement
Polaris Project. (2011b). Labor trafficking of domestic workers at-a-glance. Washington,
DC: National Human Trafficking Resource Center. Retrieved from www.
PolarisProject.org
Polaris Project. (2012). Labor trafficking in agriculture. Retrieved from http://
www.polarisproject.org/human-trafficking/labor-trafficking-in-the-us/
agriculture-a-farms
Polaris Project. (2013, February 27). Wyoming becomes 50th state to outlaw human trafficking [Press release]. Retrieved from http://www.polarisproject.org/media-center/
press-releases/742-wyoming-becomes-50th-state-to-outlaw-human-trafficking
Polaris Project, (n.d.). Domestic sex trafficking: The criminal operations of the American
web.ca/home/catw/attach/CATW%20Comparative%20Study%202002.pdf
Raymond, J., & Hughes, D. (2001). Sex trafficking of women in the United States:
International and domestic trends. Retrieved from http://www.uri.edu/artsci/wms/
hughes/sex_traff_us.pdf
Reid, J. A. (2010). Doors wide shut: Barriers to the successful delivery of victim services
for domestically trafficked minors in a southern U.S. metropolitan area. Women &
Criminal Justice, 20(1), 147-166.
Reid, J. A. (2011). An exploratory model of girls’ vulnerability to commercial sexual
exploitation in prostitution. Child Maltreatment, 16(2), 146-157.
Reid, J. A., & Jones, S. (2011). Exploited vulnerability: Legal and psychological
perspectives on child sex trafficking victims. Victims & Offenders, 6(2), 207-231.
Rekart, M. (2005). Sex-work harm reduction. Lancet, 366, 2123–2134.
Rieger, A. (2007). Missing the mark: Why the Trafficking Victims Protection Act fails to
protect sex trafficking victims in the United States. Harvard Journal of Law &
Gender, 30, 231-256.
Robinson, R., & Paramo, P. (2007). Juvenile prostitution and community rehabilitation: An
pimp: A condensed guide for service providers and law enforcement. Retrieved
exploratory analysis of beliefs and values. Journal of Community & Applied Social
from http://www.dcjs.virginia.gov/victims/humantrafficking/vs/documents/
Psychology, 17(3), 237-247.
Domestic_Sex_Trafficking_Guide.pdf
81
depaul.edu/centers_institutes/family_law/pdf/sex_trafficking.pdf
Raphael, J., & Myers-Powell, B. (2010). From victims to victimizers: Interviews with 25
Roe-Sepowitz, D. E. (2012). Juvenile entry into prostitution: The role of emotional abuse.
Violence Against Women, 18(5), 562-579.
Ross, C. A., Anderson, G., Heber, S., & Norton, G. R. (1990). Dissociation and abuse among
multiple-personality patients, prostitutes, and exotic dancers. Hospital and
Community Psychiatry, 41, 328-330.
Ross, C. A., Farley, M., & Schwartz, H. L. (2003). Dissociation among women in
prostitution. In M. Farley (Ed.), Prostitution, trafficking, and traumatic stress (pp.
33-74). Binghamton, NY: Haworth Maltreatment & Trauma Press.
Rotheran-Borus, M. J., Mahler, K. A., Koopman, C., & Langabeer, K. (1996). Sexual abuse
history and associated multiple risk behavior in adolescent runaways. American
Journal of Orthopsychiatry, 66, 390-400.
Roxburgh, A., Degenhardt, L., & Copeland, J. (2006). Posttraumatic stress disorder among
female street-based sex workers in the greater Sydney area, Australia. BMC
Report of the Task
Psychiatry, 6, 24-35.
Force on Trafficking
of Women and Girls
Ryan, C., & Lindgren, S. (1999). How to work effectively with girls: Promising practices in
gender-specific interventions. Reaching Today’s Youth 3(3), 55-58.
Saewyc, E. M., & Edinburgh, L. D. (2010). Restoring healthy developmental trajectories for
sexually exploited young runaway girls: Fostering protective factors and reducing
risk behaviors. Journal of Adolescent Health, 46(2), 180-188. doi:10.1016/j.
jadohealth.2009.06.010
Saewyc, E. M., MacKay, L. J., Anderson, J., & Drozda, C. (2008). It’s not what you think:
Sexually exploited youth in British Columbia. Vancouver, BC: University of British
Columbia, School of Nursing. Retrieved from http://www.nursing.ubc.ca/PDFs/
ItsNotWhatYouThink.pdf
Salas, E., Cooke, N. J., & Rosen, M. A. (2008). On teams, teamwork, and team performance:
Discoveries and developments. Human Factors: Journal of the Human Factors and
Ergonomics Society, 50, 540-547.
Sallman, J. (2010). Living with stigma: Women’s experiences of prostitution and substance
use. Affilia: Journal of Women and Social Work, 25(2), 146-159.
Sanders, T. (2007). Becoming an ex-sex worker: Making transitions out of a deviant career.
Feminist Criminology, 2, 74-95.
Santos, A. (with N. Belarmino & R. B. Ignacio). (2002). The Philippines: Migration and
trafficking in women. In J. G. Raymond et al. (Eds.), A comparative study of women
trafficked in the migration process: Patterns, profiles and health consequences
of sexual exploitation in five countries (Indonesia, the Philippines, Thailand,
Venezuela and the United States). N. Amherst, MA: Coalition Against Trafficking
in Women. Retrieved from http://action.web.ca/home/catw/attach/CATW%20
Comparative%20Study%202002.pdf
Sarkar, K., Bal, B., Mukherjee, R., Chakraborty, S., Saha, S., Ghosh, A., & Parsons, S.
(2008). Sex-trafficking, violence, negotiating skill, and HIV infection in brothelbased sex workers of Eastern India, adjoining Nepal, Bhutan, and Bangladesh.
Journal of Health Population and Nutrition, 26(2), 223-231.
Scaer, R. B. (2001). The body bears the burden: Trauma, dissociation & disease.
Binghamton, NY: Haworth.
Schank, R., & Abelson, R. (1977). Scripts, plans, goals, and understanding: An inquiry into
human knowledge structure. Hillsdale, NJ: Erlbaum.
Schapiro Group. (2010, Fall/Winter). Research sheds new light for battling commercial
sexual exploitation of children. eUpdate. Retrieved from http://www.schapirogroup.
com/eUpdate/eUpdate_fall-winter10.htm
Schauer, E. J., & Wheaton, E. M. (2006). Sex trafficking into the United States: A literature
review. Criminal Justice Review, 31(2), 146-169.
Schissel, B., & Fedec, K. (1999). The selling of innocence: The Gestalt of danger in the
lives of youth prostitutes. Canadian Journal of Criminology, 41, 33-56.
Schloenhardt, A., & Loong, M. (2011). Return and reintegration of human trafficking
victims from Australia. International Journal of Refugee Law, 23(2), 143-173.
Schoenberg, J., Riggins, T., & Salmond, K. (2003). Feeling safe—What girls say. New York,
NY: Girls Scouts of the USA.
Seabrook, J. (2001). Children of other worlds: Exploitation in the global market. London,
England: Pluto.
Senn, T. E., & Carey, M. P. (2010). Child maltreatment and women’s adult sexual risk
behavior: Childhood sexual abuse as a unique risk factor. Child Maltreatment,
15(4), 324-335.
Sex Workers Project. (2009). The use of raids to fight trafficking in persons. New York, NY:
Urban Justice Center.
Shannon, K., Kerr, T., Allinott, S., Chettiar, J., Shoveller, J., & Tyndall, M. W. (2008). Social
and structural violence and power relations in mitigating HIV risk of drug-using
women in survival sex work. Social Science & Medicine, 66(4), 911-921.
82
Shannon, S. (1999). Prostitution and the mafia: The involvement of organized crime in the
global sex trade. In P. Williams (Ed.), Illegal immigration and commercial sex: The
new slave trade (pp. 119-144). London, UK: Frank Cass.
Shared Hope International. (2007). Demand: A comparative examination of sex tourism and
trafficking in Jamaica, Japan, the Netherlands, and the United States. Retrieved
from http://www.sharedhope.org/Portals/0/Documents/DEMAND.pdf
Shelley, L. (2007). Human trafficking as a form of transnational crime. In M. Lee (Ed.),
Human trafficking (pp. 116-137). Portland, OR: Willan Press.
Shelley, L. (2010). Human trafficking: A global perspective. Cambridge, England:
Cambridge University Press.
Shigekane, R. (2007). Rehabilitation and community integration of trafficking survivors in
the United States. Human Rights Quarterly, 29, 112-136.
Shinkle, W. (2007). Preventing human trafficking: An evaluation of current efforts.
Transatlantic Perspectives on Migration (Policy Brief #3). Washington, DC:
Georgetown University, Institute for the Study of International Migration.
Shively, M., Kliorys, K., Wheeler, K., & Hunt, D. (2012). A national overview of sex
trafficking and prostitution demand reduction efforts: Final report. Cambridge,
MA: Abt Associates.
Sidun, N. M., & Rubin, D. A. (2013). Sex trafficking of women. In J. A. Sigal & F. L. Denmark
(Eds.), Violence against women and girls: International perspectives: Vol. 2. In
adulthood, midlife, and older age (pp.159-182). Santa Barbara, CA: Praeger.
Silbert, M. H., & Pines, A. M. (1981). Sexual child abuse as an antecedent to prostitution.
Child Abuse & Neglect, 5(4), 407-411.
Silbert, M., & Pines, A. (1982a). Entrance into prostitution. Youth and Society, 13(4),
471-500.
Silbert, M. H., & Pines, A. M. (1982b). Victimization of street prostitutes. Victimology
Annual, 7(1-4), 122-133.
Silverman, J. G. (2011). Adolescent female sex workers: Invisibility, violence and HIV.
Archives of Disease in Childhood, 96, 478-481.
Silverman, J. G., Decker, M. R., Gupta, J., Maheshwari, A., Willis, B. M., & Raj, A. (2007).
HIV prevalence and predictors of infection in sex-trafficked Nepalese girls and
women. Journal of the American Medical Association, 298, 536-542.
Simons, R. L., & Whitbeck, L. B. (1991). Sexual abuse as a precursor to prostitution and
victimization among adolescents and adult homeless women. Journal of Family
Issues, 12(3), 361-379.
Siskin, A., & Sun Wyler, L. (2010). Trafficking in persons: Policies and issues for Congress.
Washington, DC: Congressional Research Service.
Small, K., Adams, W., Owens, C., & Roland, K. (2008). An analysis of federally prosecuted
CSEC cases since the passage of the Victims of Trafficking and Violence
Prevention Act of 2000. Washington, DC: Urban Institute Justice Policy Center.
Retrieved from https://www.ncjrs.gov/pdffiles1/ojjdp/grants/222023.pdf
Smikowski, J., Dewane, S., Johnson, M. E., Brems, C., Bruss, C., & Roberts, L. (2009).
Community-based participatory research for improved mental health. Ethics &
Behavior, 19, 461-478. doi:10.1080/10508420903274971
Smith, L. A., Vardaman, S. H., & Snow, M. A. (2009). The national report on domestic
minor sex trafficking: America’s prostituted children. Vancouver, WA: Shared Hope
International. Retrieved from http://sharedhope.org/wp-content/uploads/2012/09/
SHI_National_Report_on_DMST_2009without_cover.pdf
Smith, P. L., & Moss, S. B. (2009). Psychologist impairment: What it is, how can it be
prevented, and what can be done to address it? Clinical Psychology: Science and
Practice, 16, 1-15.
Smoller, J. (2001). Homeless youth in the United States. Prevention Researcher 8(3), 1-5.
Southern Poverty Law Center. (2013, February). A brief history of guestworkers in
America. Retrieved from http://www.splcenter.org/publications/close-to-slaveryguestworker-programs-in-the-united-states/a-brief-history-of-guestwork
Srikantiah, J. (2007). Perfect victims and real survivors: The iconic victims in domestic
human trafficking law. Boston University Law Review, 87, 157-204.
Stachowiak, J. A., Sherman, S., Konakova, A., Krushkova, I., Beyrer, C., Peryshkina, A., &
Strathdee, S. (2005). Health risks and power among female sex workers in Moscow.
SIECUS Report, 33(2), 18-25.
Stark, C., & Hodgson, C. (2003). Sister oppressions: A comparison of wife battering and
prostitution. In M. Farley (Ed.), Prostitution, trafficking, and traumatic stress.
Binghamton, NY: The Haworth Press, Inc.
Steglich, E. (Ed.). (2005). In modern bondage: Sex trafficking in the Americas. Chicago, IL:
International Human Rights Law Center, Depaul University College of Law.
Steinberg, L., & Cauffman, E. (1996). Maturity of judgment in adolescence: Psychosocial
factors in adolescent decision-making. Law & Human Behavior 20(3), 249-272.
Retrieved from http://www.psycontent.com/content/c06520g33n078137/
Steinberg, L., & Scott, E. (2003). Less guilty by reason of adolescence: Developmental
immaturity, diminished responsibility, and the juvenile death penalty. American
Psychologist, 58, 1009–1018.
Sternberg, R. J. (Ed.). (2007). Career paths in psychology: Where your degree can take you
(2nd ed.). Washington, DC: American Psychological Association.
Stevens, L. E., & Fiske, S. T. (1995). Motivation and cognition in social life: A social
survival perspective, Social Cognition, 13, 189-214.
Stransky, M., & Finkelhor, D. (2008). How many juveniles are involved in prostitution in
the U.S.? University of New Hampshire, Crimes Against Children Research Center.
Retrieved from http://www.unh.edu/ccrc
References
Strasser, T. (1978). Reflections on cardiovascular diseases. Interdisciplinary Science
Reviews, 3, 225–230.
Streissguth, A. (2005, May 4). FASD: Juvenile justice and the community. Paper presented
at the launch of the Hennepin County Juvenile Justice Project. Minneapolis MN.
Sturdevant, S., & Stoltzfus, B. (1992). Let the good times roll: Prostitution and the U.S.
military in Asia. New York, NY: New Press.
Sulaimanova, S. (2006). Trafficking in women from the former Soviet Union for the
purposes of sexual exploitation. In K. Beeks & D. Amir (Eds.), Trafficking and the
global sex industry (61-77). Lanham, MD: Lexington Books.
Sweeney, P., Lindegren, M., Buehler, J., Onorato, I., & Janssen, R. (1995). Teenagers at risk
of human immunodeficiency virus type 1 infection: Results from seroprevalence
surveys in the United States. Archives of Pediatrics and Adolescent Medicine 149,
521–528.
Sweet, L. (2012, September 25). Obama at Clinton Global Initiative: Hits at sex slavery.
Transcript. Chicago Sun-Times. Retrieved from http://blogs.suntimes.com/
sweet/2012/09/obama_at_clinton_global_initia.html
Tang, C. S., & Lee, Y. K. (1999). Knowledge of sexual abuse and self-protection skills: A
study of female Chinese adolescents with mild mental retardation. Child Abuse &
Neglect, 23(3), 269-279.
Terrell, N. E. (1997). Street life: Aggravated and sexual assaults among homeless and
runaway adolescents. Youth & Society, 28(3), 267-290.
Tharinger, D., Horton, C. B., & Millea, S. (1990). Sexual abuse and exploitation of children
and adults with mental retardation and other handicaps. Child Abuse & Neglect,
14(3), 301-312.
Thomson, S., Hirshberg, D., Corbett, A., Valila, N., & Howley, D. (2011). Residential
treatment for sexually exploited adolescent girls: Acknowledge, Commit, Transform
(ACT). Children and Youth Services Review, 33(11), 2290-2296.
Three convicted of sex trafficking, sexual slavery of Latin American women in New York.
(2011, May 27). Latin American Herald Tribune. Retrieved from http://www.laht.
com/article.asp?CategoryId=12395&ArticleId=395080
Thukral, J. (2005). Behind closed doors: An analysis of indoor sex work in New York City.
SIECUS Report, 33(2), 3-9.
Todres, J. (2010). Taking prevention seriously: Developing a comprehensive response to
child trafficking and sexual exploitation (Legal Studies Research Paper No. 201003). Atlanta, GA: Georgia State University College of Law.
Todres, J. (2011). Moving upstream: The merits of a public health law approach to human
trafficking. North Carolina Law Review, 89(2), 447-506.
Trafficking Victims Protection Act, 22 U.S.C. § 7101 (b)(2). (2000).
Trafficking Victims Protection Reauthorization Act, P.L. 108-193. (2003).
Trafficking Victims Protection Reauthorization Act, 22 USC § 7104. (2005).
Trujillo, A. (2004). Slavery in the 21st century. Americas (English ed.), 56(2), 60-61.
Tsutsumi, A., Izutsu, T., Poudyal, A. K., Kato, S., & Marui, E. (2008). Mental health of
female survivors of human trafficking in Nepal. Social Science & Medicine, 66,
1841-1847.
Twill, S. E., Green, D. M., & Traylor, A. (2010). A descriptive study on sexually exploited
children in residential treatment. Child Youth Care Forum, 39, 187-199.
Tyldum, G. (2010). Limitations in research on human trafficking. International Migration,
48(5), 1-13. doi:10.1111/j.1468-2435.2009.00597.x
Tyler, K., Hoyt, D., & Whitbeck, L. (2000). The effects of early sexual abuse on later sexual
victimization among female homeless and runaway adolescents. Journal of
Interpersonal Violence, 15, 235–250.
Tyler, K. A., & Johnson, K. A. (2006). Trading sex: Voluntary or coerced? The experience of
homeless youth. Journal of Sex Research, 43, 208-216.
83
Tyler, K. A., Whitbeck, L. B., Hoyt, D. R., & Cauce, A. M. (2004). Risk factors for sexual
victimization among male and female homeless runaway youth. Journal of
Interpersonal Violence, 19, 503-520.
Tyler, K., Whitbeck, L., Hoyt, D., & Yoder, K. (2000). Predictors of self-reported sexually
transmitted diseases among homeless and runaway adolescents. Journal of Sex
Research 37(4), 269-377.
Ugarte, M. B., Zarate, L., & Farley, M. (2003). Prostitution and trafficking of women
and children from Mexico to the United States. In M. Farley (ed.), Prostitution,
trafficking and traumatic stress (pp. 147-156). New York, NY: Routledge.
United Nations. (1948). Universal declaration of human rights. Retrieved from http://www.
un.org/en/documents/udhr/
United Nations. (1949). Convention on the suppression of the traffic in persons and of the
exploitation of the prostitution of others (96 U.N.T.S. 271). Retrieved from http://
www1.umn.edu/humanrts/instree/trafficinperson.htm
United Nations. (1993). Declaration on the elimination of violence against women.
Retrieved from http://www.un.org/documents/ga/res/48/a48r104.htm
United Nations. (2000). Protocol to prevent, suppress and punish trafficking in persons,
especially women and children, supplementing the United Nations Convention
Against Transnational Organized Crime. Retrieved from http://www.uncjin.org/
Documents/Conventions/dcatoc/final_documents_2/convention_%20traff_eng.pdf
United Nations. (2008). Summary of the General Assembly thematic debate on
human trafficking. Retrieved from http://www.un.org/ga/president/62/letters/
htraffickingsummary280708.pdf
United Nations Department of Economics and Social Affairs. (2009). State of the
world’s indigenous people. Retrieved from http://www.un.org/esa/socdev/unpfii/
documents/SOWIP_web.pdf
United Nations Development Fund for Women (UNIFEM). (2002). Women forced to flee. In
Progress of the world’s women 2002. Vol. 1: Women, war, and peace. New York, NY:
UNIFEM. Retrieved from http://hdrnet.org/549/5/214_chapter02.pdf
United Nations High Commissioner for Refugees. (2010). 2009 global trends: Refugees,
asylum-seekers, returnees, internally displaced and stateless persons. Retrieved
from http://www.unhcr.org/4c11f0be9.html
United Nations Office on Drugs and Crime (UNODC). (2009). The global report on
trafficking in persons. Retrieved from http://www.unodc.org/documents/Global_
Report_on_TIP.pdf
United Nations Office on Drugs and Crime (UNODC). (2010). Organized crime involvement
in trafficking in persons and smuggling of migrants. Retrieved from http://www.
unodc.org/documents/human-trafficking/FINAL_REPORT_06052010_1.pdf
United Nations Office on Drugs and Crime. (2011). The role of corruption in trafficking in
persons. Retrieved from http://www.unodc.org/documents/human-trafficking/2011/
Issue_Paper_-_The_Role_of_Corruption_in_Trafficking_in_Persons.pdf
United Nations Office on Drugs and Crime. (2012). Blue Heart Campaign against human
trafficking. Retrieved from http://www.unodc.org/blueheart/
United Nations Office on Drugs and Crime. (2013). UNODC human trafficking case law
database. Retrieved from http://www.unodc.org/cld/index.jspx
United Nations Population Fund. (2009). State of world population 2009: Facing a
changing world: Women, population, and climate. Retrieved from http://www.
unfpa.org/swp/2009/en/pdf/EN_SOWP09.pdf
United Nations Population Fund. (n.d.). Gender equality: A cornerstone of development.
Retrieved from http://www.unfpa.org/gender
United States v. Abdel Nasser Youssef Ibrahim (2006). Retrieved from http://www.law.
umich.edu/clinical/HuTrafficCases/Pages/CaseDisp.aspx?caseID=9
United States v. Abdenasser Ennassime (2006). Retrieved from http://www.law.umich.edu/
clinical/HuTrafficCases/Pages/CaseDisp.aspx?caseID=10
United States v. Abrorkhodja Askarkhodjaev, 2010 U.S. Dist. Lexis 107171 (W.D. Mo. Sept.
8, 2010).
United States v. Akouavi Kpade Afolabi (2009). Retrieved from http://www.law.umich.edu/
clinical/HuTrafficCases/Pages/CaseDisp.aspx?caseID=15
United States v. Corey Davis, 2008 U.S. Dist. Lexis 99802 (D. Conn. Nov. 26, 2008).
United States v. Calimlim, 2006 U.S. Dist. Lexis 5536 (E.D. Wis. Jan. 27, 2006).
United States v. Irey (2007). Retrieved from http://www.law.umich.edu/clinical/
HuTrafficCases/Pages/CaseDisp.aspx?caseID=473
United States v. Jose Tecum (2001). Retrieved from http://www.law.umich.edu/clinical/
HuTrafficCases/Pages/CaseDisp.aspx?caseID=235
United States vs. Kent Frank, 486 F. Supp. 2d 1353; 2007 U.S. Dist. Lexis 35110; 20 Fla. L.
Weekly Fed. D 820.
United States v. Kil Soo Lee, 159 F. Supp. 2d 1241, 2001 U.S. Dist. Lexis 14690 (D. Haw.
2001).
United States v. Marcus Sewell (2007). Retrieved from http://www.law.umich.edu/clinical/
HuTrafficCases/Pages/CaseDisp.aspx?caseID=218
U.S. Attorney’s Office, Eastern District of Missouri. (2009, July 22). St. Louis woman
sentenced on federal sex trafficking charges [Press release]. Retrieved from http://
www.fbi.gov/stlouis/press-releases/2009/sl072209a.htm
U.S. Attorney’s Office, Middle District of Florida. (2012, July 17). Tampa man pleads guilty
to conspiracy to engage in sex trafficking of a minor. Retrieved from http://www.
justice.gov/usao/flm/press/2012/july/2012070717_Guerrero.html
U.S. Attorney’s Office, Western District of Missouri. (2013, January 15). Lebanon man
pleads guilty, faces 20 years in prison for coercing a minor to become a sex slave.
U.S. Retrieved from http://www.justice.gov/usao/mow/news2013/bagley.ple.html
Report of the Task
Force on Trafficking
U.S. Department of Agriculture, Economic Research Service. (2011). [County-level data
sets]. Retrieved from http://www.ers.usda.gov/data-products/county-level-data-
of Women and Girls
sets/poverty.aspx
U.S. Department of Commerce & Office of Management and Budget. (2011). Women in
America: Indicators of social and economic well-being. Retrieved from http://www.
whitehouse.gov/sites/default/files/rss_viewer/Women_in_America.pdf
U.S. Department of Homeland Security. (2012). Human trafficking. Retrieved from http://
www.dhs.gov/topic/human-trafficking
U.S. Department of Justice. (2010a). The national strategy for child exploitation
prevention and interdiction. Retrieved from http://www.justice.gov/psc/docs/
natstrategyreport.pdf
U.S. Department of Justice. (2010b, September 2). Six people charged in human trafficking
conspiracy for exploiting 400 Thai farm workers. Retrieved from http://www.justice.
gov/opa/pr/2010/September/10-crt-999.html
U.S. Department of State. (2003). Trafficking in persons report 2003. Washington, DC: U.S.
Government Printing Office.
U.S. Department of State. (2004). Trafficking in persons report 2004. Washington, DC: U.S.
Government Printing Office.
U.S. Department of State. (2005). Trafficking in persons report 2005. Washington, DC: U.S.
Government Printing Office.
U.S. Department of State. (2006). Trafficking in persons report 2006. Washington, DC: U.S.
Government Printing Office.
U.S. Department of State. (2008). Trafficking in persons report 2008. Washington, DC: U.S.
Government Printing Office.
U.S. Department of State. (2009). Rights, protections and resources [Pamphlet]. Retrieved
from http://www.travel.state.gov/visa/temp/pamphlet /pamphlet_4578.html
U.S. Department of State. (2010). Trafficking in persons report 2010. Washington, DC: U.S.
Government Printing Office.
U.S. Department of State. (2011a). The 3Ps: Prevention, protection, prosecution. Retrieved
from http://www.state.gov/documents/organization/167334.pdf
U.S. Department of State. (2011b). Trafficking in persons report 2011. Washington, DC:
U.S. Government Printing Office.
U.S. Department of State. (2012a, June 19). Release of the 2012 Trafficking in
Persons Report: Remarks. Retrieved from http://www.state.gov/secretary/
rm/2012/06/193368.htm
U.S. Department of State. (2012b). Trafficking in persons report 2012. Washington, DC:
U.S. Government Printing Office.
U.S. Department of State. (n.d.). PITF member and invited agencies. Retrieved from http://
www.state.gov/j/tip/response/usg/agencies/index.htm
U.S. Department of State, Human Smuggling and Trafficking Center. (2006). Fact sheet:
Distinctions between human smuggling & human trafficking. Retrieved from
http://www.state.gov/documents/organization/90541.pdf
van der Kolk, B. A. (1988). The trauma spectrum: The interaction of biological and social
events in the genesis of the trauma response. Journal of Traumatic Stress, 1,
273290.
van der Laan, P. H., Smit, M., Busschers, I., & Aarten, P. (2011). Cross-border trafficking
in human beings: Prevention and intervention strategies for reducing sexual
exploitation. Campbell Systematic Reviews, 7(9), 1-50.
Van Dorn, R., Mustillo, S., Elbogen, E., Dorsey, S., Swanson, J., & Swartz, M. (2005). The
effects of early sexual abuse on adult risky sexual behaviors among persons with
severe mental illness. Child Abuse & Neglect, 29, 1265-1279.
Van Liemt, G. (2004). Human trafficking in Europe: An economic perspective (Working
paper). Geneva, Switzerland: International Labor Organization. Retrieved from
http://www.ilo.org/wcmsp5/groups/public/---ed_norm/---declaration/documents/
publication/wcms_081992.pdf
Vanwesenbeeck, I. (1994). Prostitutes’ well-being and risk. Amsterdam, the Netherlands:
VU University Press.
Venkatraman, B. A. (2003). Human trafficking: A guide to detecting,
investigating, and punishing modern-day slavery. The Police Chief,
70(12). Retrieved from http://policechiefmagazine.org/magazine/index.
cfm?fuseaction=display_arch&article_id=174&issue_id=122003
Verité. (2010). Help wanted: Hiring, human trafficking and modern-day slavery in the
global economy. Amherst MA: Author. Retrieved from http://digitalcommons.ilr.
cornell.edu/cgi/viewcontent.cgi?article=2135&context=globaldocs
Vijeyarasa, R., & Stein, R. A. (2010). HIV and human trafficking- related stigma: Health
interventions for trafficked populations. JAMA: Journal of the American Medical
Association, 304(3), 344-345.
Ward, A., & Roe-Sepowitz, D. (2009). Assessing the effectiveness of a trauma-oriented
approach to treating prostituted women in a prison and community exiting
program. Journal of Aggression, Maltreatment, & Trauma, 18(3), 293-312.
doi:10.1080/1092677090280983
Watts, C., & Zimmerman, C. (2002). Violence against women: Global scope and magnitude.
Lancet, 359, 1232-1237.
Webber, A., & Shirk, D. (2005). Hidden victims: Evaluating protections for undocumented
victims of human trafficking. Immigration Policy in Focus, 4(8), 1-10.
Weiner, N. A., & Hala, N. (2008). Measuring human trafficking: Lessons from New York City.
Washington DC: National Institute of Justice. Retrieved from http://www.ncjrs.gov/
pdffiles1/nij/grants/224391.pdf
Weitzer, R. (2010). The movement to criminalize sex work in the United States. Journal of
Law and Society, 37(1), 61-84.
Whitbeck, L. (2000). The effects of early sexual abuse on later sexual victimization among
female homeless and runaway adolescents. Journal of Interpersonal Violence, 15,
235–250.
Whitbeck, L., & Hoyt, D. (1999). Nowhere to grow: Homeless and runaway adolescents and
their families. Hawthorne, NY: Walter de Gruyter.
Whitbeck, L., Hoyt, D., & Ackley, K. (1997). Abusive family backgrounds and later
victimization among runaway and homeless adolescents. Journal of Research on
Adolescence, 7, 375-392.
Whitbeck, L., Hoyt, D., & Yoder, K. (1999). A risk-amplification model of victimization and
depressive symptoms among runaway and homeless adolescents. American Journal
of Community Psychology, 27, 273-296.
Whitbeck, L. B., & Simons, R. L. (1990). Life on the streets: The victimization of runaway
and homeless adolescents. Youth & Society, 22(1), 108-126.
Whitbeck, L. B., & Simons, R. L. (1993). A comparison of adaptive strategies and patterns
of victimization among homeless adolescents and adults. Violence and Victims,
8(2), 135-152.
White House, Office of the Press Secretary. (2012). Presidential proclamation – National
U.S. Immigration and Customs Enforcement (ICE). (2010). Continued presence: Temporary
Slavery and Human Trafficking Prevention Month, 2013 [Press release].
immigration status for victims of human trafficking. Washington, DC: U.S.
Retrieved from http://www.whitehouse.gov/the-press-office/2012/12/31/
Department of Homeland Security.
U.S. v. Adriana Paoletti-Lemus (1998). Retrieved from http://www.law.umich.edu/CLINICAL/
HUTRAFFICCASES/Pages/CaseDisp.aspx?caseID=196
U.S. v. Lynda Dieu Phan, Justin Phan, Duc Cao Nguyen (2009). Retrieved from http://www.
presidential-proclamation-national-slavery-and-human-trafficking-prevent
Widom, C. S. (1995). Victims of childhood sexual abuse—Later criminal consequences.
Research in Brief. Washington, DC: U.S. Department of Justice, Office of Justice
Programs, National Institute of Justice.
law.umich.edu/CLINICAL/HUTRAFFICCASES/Pages/CaseDisp.aspx?caseID=287
Widom, C., & Ames, M. (1994). Criminal consequences of childhood sexual victimization.
U.S. v. Theresa Mubang. (2004). Retrieved from http://www.law.umich.edu/CLINICAL/
Child Abuse & Neglect, 18(4), 303-318. Retrieved from http://www.sciencedirect.
HUTRAFFICCASES/Pages/CaseDisp.aspx?caseID=228
Vancouver/Richmond Health Board. (1999). Healing ways: Aboriginal health and service
review. Retrieved from http://www.vch.ca/community/Docs/healing_ways.pdf
84
com/science/article/pii/0145213494900337
Widom, C. S., & Kuhns, J. B. (1995). Childhood victimization and subsequent risk for
promiscuity, prostitution, and teenage pregnancy: A prospective study. American
Journal of Public Health, 86(11), 1607-1612.
Williams, L. M. (2010). Harm and resilience among prostituted teens: Broadening our
understanding of victimisation and survival. Social Policy and Society, 9, 243-254.
doi:10.1017/S1474746409990376
Williams, L. M. (2011). Community responsibility for runaway and thrownaway youth—
Commentary. Journal of Applied Research on Children: Informing Policy for
Children at Risk, 2(1), 1-7. Retrieved from http://digitalcommons.library.tmc.edu/
childrenatrisk/vol2/iss1/11
Williams, L. M., & Frederick, M. E. (2009). Pathways into and out of commercial sexual
victimization of children: Understanding and responding to sexually exploited
teens. Lowell, MA: University of Massachusetts Lowell. Retrieved from http://
References
faculty.uml.edu/lwilliams/Williams%20Pathways%20Final%20Report%202006MU-FX-0060%2010-31-09L.pdf
Williamson, C., & Folaron, G. (2003). Understanding the experiences of street level
prostitutes. Qualitative Social Work, 2(3), 271-286.
Williamson, C., & Prior, M. (2009). Domestic minor sex trafficking: A network of
underground players in the Midwest. Journal of Child & Adolescent Trauma, 2,
1-16.
Williamson, E., Dutch, N., & Clawson, H. (2009). National symposium on the health needs
of human trafficking victims: Post-symposium brief. Retrieved from http://aspe.
hhs.gov/hsp/07/humantrafficking/Symposium/ib.pdf
Williamson, E., Dutch, N. M., & Clawson, H. J. (2010). Evidence-based mental health
treatment for victims of human trafficking. Washington, DC: U.S. Department
of Health and Human Services. Retrieved from http://aspe.hhs.gov/hsp/07/
humantrafficking/mentalhealth/index.pdf
Willoughby, M., & Lee, S. (2008). Demand deterrence strategies: International initiatives to
eliminate demand for the sex trade. Chicago, IL: Chicago Alliance Against Sexual
Exploitation. Retrieved from http://g.virbcdn.com/_f/files/ad/FileItem-149840DemandDeterrence.pdf
Wolak, J., Finkelhor, D., Mitchell, K., & Ybarra, M. (2008). Online “predators” and their
victims: Myths, realities, and implications for prevention and treatment. American
Psychologist, 63, 111-128. doi:10.1037/0003-066X.63.2.111
Yakushko, O. (2008). Building collaborations to work on issues related to human
trafficking. Psychology International, 19, 9-10.
Yakushko, O. (2009). Human trafficking: A review for mental health professionals.
International Journal for the Advancement of Counseling, 31(3), 158-167.
Yassen, J. (1995). Preventing secondary traumatic stress disorder. In C. R. Figley, (Ed.),
Compassion fatigue: Coping with secondary traumatic stress disorder in those
who treat the traumatized (pp. 178-208). New York, NY, & London, England:
Brunner-Routledge.
Yea, S. (2005). Runaway brides: Anxieties of identity among trafficked Filipina entertainers
in South Korea. Singapore Journal of Tropical Geography, 25(2), 180-197.
Yen, I. (2008). Of vice and men: A new approach to eradicating sex trafficking by reducing
male demand through educational programs and abolitionist legislation. Journal of
Criminal Law and Criminology, 98(2), 653-686.
Young, A. M., Boyd, C., & Hubbell, A. (2000). Prostitution, drug use, and coping with
psychological distress. Journal of Drug Issues, 30(4), 789-800.
Zhang, S. X. (2009). Beyond the Natasha story: A review and critique of current research
on sex trafficking. Global Crime, 10(3), 178-195.
Zhang, S. (2011). Sex trafficking in a border community: A field study of sex trafficking in
Tijuana, Mexico. Retrieved from https://www.ncjrs.gov/pdffiles1/nij/grants/234472.pdf
Zhou, M. (2003). Contemporary female immigration to the United States: A demographic
profile. In P. Strum & D. Tarantolo, (Eds.), Women immigrants in the United States
(pp. 23-34). Washington, DC: Woodrow Wilson International Center for Scholars
and the Migration Policy Institute. Retrieved from http://www.wilsoncenter.org/
sites/default/files/womenimm_rpt.pdf
Zimmerman, C., Hossain, M., Yun, K., Gajdadziev, V., Guzun, N., Tchomarova, M., … Watts,
C. (2008). The health of trafficked women: A survey of women entering
posttrafficking services in Europe. American Journal of Public Health, 98(1), 55-59.
Zimmerman, C., Hossain, M., Yun, K., Roche, B., Morison, L., & Watts, C. (2006). Stolen
smiles: A summary report on the physical and psychological health consequences
of women and adolescents trafficked in Europe. London, UK: The London School
of Hygiene & Tropical Medicine. Retrieved from http://www.lshtm.ac.uk/php/ghd/
docs/stolensmiles.pdf
85
Zimmerman, C., Kiss, L., & Hossain, M. (2011). Migration and health: A framework for 21st
century policy-making. PloS Medicine, 8(5), 1-7.
Zimmerman, C., & Watts, C. (2003). WHO ethical guidelines and safety recommendations
for interviewing trafficked women. Geneva, Switzerland: World Health Organization.
Zimmerman, C., Yun, K., Shvab, I., Watts, C., Trappolin, L., Treppete, M., … Regan,
L. (2003). The health risks and consequences of trafficking in women and
adolescents: Findings from a European study. London, England: London School of
Hygiene & Tropical Medicine (LSHTM).
AMERICAN
PSYCHOLOGICAL
ASSOCIATION
PUBLIC INTEREST DIRECTORATE
Women’s Programs Office
750 First Street, NE
Washington, DC 20002-4242
202-336-6044
www.apa.org/pi/women